NPI:
1225404551
Provider Name:
FAMILY RENEWED, LLC
Doing Business As: DAWN M. PORTER, MD
Classification:
Psychiatry & Neurology - 2084P0804X
Entity Type:
Organization
Specialization: Child & Adolescent Psychiatry
Address:
1004 PEBBLE BEACH DR
CASEYVILLE, IL
ZIP 62232
Phone:
(913) 461-0369
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FAMILY RENEWED, LLC is a child and adolescent psychiatry psychiatry neurology in Caseyville, IL. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. FAMILY RENEWED, LLC NPI is 1225404551. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Dawn M. Porter, Md.
The provider's business location address is:
1004 PEBBLE BEACH DR
CASEYVILLE, IL
ZIP 62232-834
Phone: (913) 461-0369
Fax: (913) 461-0832
The provider's authorized official is Dawn Michelle Porter .
The authorized official title is Founder/ceo and has the following contact phone number (913) 461-0369.
The enumeration date for this NPI number is 8/21/2015 and was last updated on 8/21/2015.