| NPI | 1093307266 |
|---|---|
| Doing Business As | RENEST RECOVERY SUPPORT SERVICE ROCKFORD LLC |
| Entity Type | Organization |
| Authorized Contact | CHRISTINA NICOLE HOBSON Authorized Official, Human Resource 270-839-6743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2022-11-03 |