Provider Demographics
NPI:1225685647
Name:RENEW HOPE LLC
Entity Type:Organization
Organization Name:RENEW HOPE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOVAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCCLARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-667-0173
Mailing Address - Street 1:4008 S HARMON ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46953-4969
Mailing Address - Country:US
Mailing Address - Phone:765-667-0173
Mailing Address - Fax:
Practice Address - Street 1:4008 S HARMON ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-4969
Practice Address - Country:US
Practice Address - Phone:765-667-0173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty