Provider Demographics
NPI:1669252631
Name:ANEW HEALING CENTER LLC
Entity type:Organization
Organization Name:ANEW HEALING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOESE
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:319-481-8828
Mailing Address - Street 1:2708 BLAZING STAR DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6849
Mailing Address - Country:US
Mailing Address - Phone:319-541-6705
Mailing Address - Fax:
Practice Address - Street 1:332 S LINN ST STE 31A
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-1697
Practice Address - Country:US
Practice Address - Phone:319-481-8828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)