Organization
REMEDIES RENEWING LIVES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY S. BRANNING M.S., LCPC, CADC, (VP OF MARKETING/FUND DEVELOPMENT)
(815) 966-1285
Entity
Organization
Contact information
Practice address
1908 PIERCE CT, BELVIDERE, IL 61008-1742
(815) 547-4502
(815) 544-0391
Mailing address
220 EASTON PKWY, ROCKFORD, IL 61108-2203
(815) 966-1285
(815) 962-7895
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720259401
—
IL
Enumeration date
10/22/2018
Last updated
10/22/2018
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