Renewed Medical Center LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

RENEWED MEDICAL CENTER LLC

Practice address

29787 John J Williams Hwy #6
Millsboro, DE 19966-4097

Phone

(302) 648-2733

NPI assigned

Sep 29, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Adaeza Udezue, MD

Title

Owner/President

Phone

(302) 648-2733

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1538179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543449600000",
    "number": "1972088516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29787 JOHN J WILLIAMS HWY #6",
            "city": "MILLSBORO",
            "state": "DE",
            "postal_code": "199664097",
            "telephone_number": "302-648-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29787 JOHN J WILLIAMS HWY #6",
            "city": "MILLSBORO",
            "state": "DE",
            "postal_code": "199664097",
            "telephone_number": "302-648-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWED MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-29",
        "last_updated": "2018-11-29",
        "status": "A",
        "authorized_official_last_name": "UDEZUE",
        "authorized_official_first_name": "ADAEZA",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "302-648-2733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Millsboro, DE
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.