| Renee Rose, LLC | |
|
2084 Pinewood St Jenison MI 49428-9117 | |
| (616) 888-5585 | |
| Not Available |
| Full Name | Renee Rose, LLC |
|---|---|
| Speciality | Counselor |
| Location | 2084 Pinewood St, Jenison, Michigan |
| Authorized Official Name and Position | Renee Rose (OWNER) |
| Authorized Official Contact | 6168885585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renee Rose, LLC Po Box 851 Jenison MI 49429-0851 Ph: (616) 888-5585 | Renee Rose, LLC 2084 Pinewood St Jenison MI 49428-9117 Ph: (616) 888-5585 |
| NPI Number | 1114587375 |
|---|---|
| Provider Enumeration Date | 06/19/2019 |
| Last Update Date | 02/20/2023 |
| Certification Date | 02/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114587375 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (NU) | Primary |
| 101YM0800X | Counselor - Mental Health | (NU) | Secondary |
| 101YP2500X | Counselor - Professional | (NU) | Secondary |
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