Re-New Life

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

RE-NEW LIFE

Practice address

33204 E. R.D. Mize Road
Grain Valley, MO 64029

Phone

(816) 443-3311

Fax

(816) 443-3311

NPI assigned

Jun 26, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Charles P Neely

Title

Ceo

Phone

(816) 443-3311

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740486711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33204 E. R.D. MIZE ROAD",
            "city": "GRAIN VALLEY",
            "state": "MO",
            "postal_code": "64029",
            "telephone_number": "816-443-3311",
            "fax_number": "816-443-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33204 E. R.D. MIZE ROAD",
            "city": "GRAIN VALLEY",
            "state": "MO",
            "postal_code": "64029",
            "telephone_number": "816-443-3311",
            "fax_number": "816-443-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RE-NEW LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NEELY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "816-443-3311",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Grain Valley, MO
• Providers in Grain Valley, MO by specialty
• Addiction (Substance Use Disorder) Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.