Organization
RE-NEW LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES P NEELY (CEO)
(816) 443-3311
Entity
Organization
Contact information
Practice address
33204 E. R.D. MIZE ROAD, GRAIN VALLEY, MO 64029
(816) 443-3311
(816) 443-3311
Mailing address
33204 E. R.D. MIZE ROAD, GRAIN VALLEY, MO 64029
(816) 443-3311
(816) 443-3311
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/26/2007
Last updated
08/22/2020
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