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Organization
RENEW WELLNESS CENTER
Active
Organization
RENEW WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY PETERSON (CO-OWNER)
(406) 868-6163
Entity
Organization
Contact information
Practice address
2 5TH ST N STE 202, GREAT FALLS, MT 59401-4011
(406) 453-9355
(844) 274-1180
Mailing address
PO BOX 2691, GREAT FALLS, MT 59403-2691
(406) 453-9355
(844) 274-1180
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7178366
—
MT
05
—
KOVPYU3GG
—
MT
Enumeration date
07/13/2018
Last updated
07/13/2018
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