Provider Demographics
NPI:1740736933
Name:RENEWED HOPE HEALTH CLINIC
Entity Type:Organization
Organization Name:RENEWED HOPE HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-355-3053
Mailing Address - Street 1:894 MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010-1637
Mailing Address - Country:US
Mailing Address - Phone:269-355-3053
Mailing Address - Fax:269-673-4545
Practice Address - Street 1:894 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-1637
Practice Address - Country:US
Practice Address - Phone:269-355-3053
Practice Address - Fax:269-673-4545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable