Provider Demographics
NPI:1619869419
Name:RENEWED HEALTH OUTREACH AND PSYCHOTHERAPY
Entity type:Organization
Organization Name:RENEWED HEALTH OUTREACH AND PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPENHAGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-937-1920
Mailing Address - Street 1:3510 VILLAGE DR STE B
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-5363
Mailing Address - Country:US
Mailing Address - Phone:402-937-1920
Mailing Address - Fax:402-937-1955
Practice Address - Street 1:3510 VILLAGE DR STE B
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5363
Practice Address - Country:US
Practice Address - Phone:402-937-1920
Practice Address - Fax:402-937-1955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty