# CENTER FOR HEALTH RENEWAL AND LONGEVITY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881835577
- **Authorized official:** KRISTY KRUEGER (MANAGED CARE COORDINATOR)
- **Authorized official phone:** (217) 784-2364

## Contact information

- **Practice address:** 201 W SPRINGFIELD AVE, SUITE 206, CHAMPAIGN, IL 61820-4834
- **Practice address phone:** (217) 955-9554
- **Mailing address:** 201 W SPRINGFIELD AVE, SUITE 206, CHAMPAIGN, IL 61820-4834
- **Mailing address phone:** (217) 955-9554

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 209002058 | IL | Yes |

## Other

- **Enumeration date:** 03/10/2009
- **Last updated:** 10/24/2017