Organization
RENEW 4 LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA DOMPIER (OWNER)
(208) 520-1690
Entity
Organization
Contact information
Practice address
240 S 5TH W STE E, RIGBY, ID 83442-1476
(208) 520-1690
Mailing address
PO BOX 475, ASHTON, ID 83420-0475
(208) 520-1690
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/06/2010
Last updated
06/06/2010
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