Organization
RENEWED LIFE CHRISTIAN COUNSELING CENTER
Active
Other names
RLCCC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GRANT R HASTY LCSW (CEO/DIRECTOR/COUNSELOR)
(302) 275-8577
Entity
Organization
Contact information
Practice address
3135 SUMMIT BRIDGE RD, BEAR, DE 19701-2001
(302) 275-8577
(302) 454-7274
Mailing address
34 DALTON DR, NEWARK, DE 19702-2059
(302) 454-7274
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
Q1-0000765
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000035733
—
DE
05
—
1000039721
—
DE
Enumeration date
07/17/2006
Last updated
05/20/2011
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