Organization
RENEW MENTAL HEALTH AND WELLNESS, LLC
Active
Parent organization
RENEW MENTAL HEALTH AND WELLNESS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
RENEW MENTAL HEALTH AND WELLNESS LLC
Authorized official
AUTUM BRECKENRIDGE (BILLING AND CREDENTIALING)
(870) 243-3644
Entity
Organization
Contact information
Practice address
1150 E MATTHEWS AVE STE 101A, JONESBORO, AR 72401-4356
(870) 243-0424
Mailing address
1150 E MATTHEWS AVE STE 101A, JONESBORO, AR 72401-4356
(870) 243-0424
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679724504
—
AR
Enumeration date
11/11/2024
Last updated
11/11/2024
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