Provider Demographics
NPI:1326648882
Name:RE-NEW INSTITUTE LLC
Entity Type:Organization
Organization Name:RE-NEW INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:LOSEKE
Authorized Official - Last Name:ABLETT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:402-905-0630
Mailing Address - Street 1:18324 CHEYENNE RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68136
Mailing Address - Country:US
Mailing Address - Phone:402-905-0630
Mailing Address - Fax:
Practice Address - Street 1:18324 CHEYENNE RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68136
Practice Address - Country:US
Practice Address - Phone:402-905-0630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1306009758OtherNPI