| Renewed Hope Mental Health Pllc | |
|
804 Nightingale St Dearborn MI 48128-1564 | |
| (313) 318-4004 | |
| Not Available |
| Full Name | Renewed Hope Mental Health Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 804 Nightingale St, Dearborn, Michigan |
| Authorized Official Name and Position | Jean-marie Jameilla El Fakhoury (FOUNDER) |
| Authorized Official Contact | 3133184004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renewed Hope Mental Health Pllc 804 Nightingale St Dearborn MI 48128-1564 Ph: (313) 318-4004 | Renewed Hope Mental Health Pllc 804 Nightingale St Dearborn MI 48128-1564 Ph: (313) 318-4004 |
| NPI Number | 1922881580 |
|---|---|
| Provider Enumeration Date | 08/17/2023 |
| Last Update Date | 05/17/2024 |
| Certification Date | 05/17/2024 |
| Medicare PECOS PAC ID | 7416398862 |
|---|---|
| Medicare Enrollment ID | O20240528001486 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922881580 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jean Marie J El Fakhoury |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093862161 PECOS PAC ID: 0840473401 Enrollment ID: I20110321000397 |
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