Provider Demographics
NPI:1184022303
Name:RENEWED HOPE COMMUNITY SERVICES INC.
Entity Type:Organization
Organization Name:RENEWED HOPE COMMUNITY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC. V/P OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:IDOWU
Authorized Official - Last Name:KUYE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW, CRADC
Authorized Official - Phone:773-783-3579
Mailing Address - Street 1:626 E 71ST ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-1212
Mailing Address - Country:US
Mailing Address - Phone:773-783-3579
Mailing Address - Fax:773-783-3592
Practice Address - Street 1:626 E 71ST ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-1212
Practice Address - Country:US
Practice Address - Phone:773-783-3579
Practice Address - Fax:773-783-3592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-22
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-3536-0001-A261QM2800X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone