| Renewed1 LLC | |
|
401 Ryland St Ste 200a Reno NV 89502-1643 | |
| (702) 350-1387 | |
| Not Available |
| Full Name | Renewed1 LLC |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 401 Ryland St Ste 200a, Reno, Nevada |
| Authorized Official Name and Position | Amon Denzel Lester (OWNER) |
| Authorized Official Contact | 7023501387 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renewed1 LLC 401 Ryland St Ste 200a Reno NV 89502-1643 Ph: (702) 350-1387 | Renewed1 LLC 401 Ryland St Ste 200a Reno NV 89502-1643 Ph: (702) 350-1387 |
| NPI Number | 1316772387 |
|---|---|
| Provider Enumeration Date | 09/07/2024 |
| Last Update Date | 09/07/2024 |
| Certification Date | 09/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316772387 | NPI | - | NPPES |
| 1194389569 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
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