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RENU LIFE LLC NPI 1255485959


NPI Information

NPI: 1255485959
Provider Name: RENU LIFE LLC
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
102 TINDERWOOD DR
GOLDSBORO, NC
ZIP 27534
Phone: (919) 734-0266
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RENU LIFE LLC is an adult care home custodial care facility in Goldsboro, NC. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. RENU LIFE LLC NPI is 1255485959. The provider is registered as an organization entity type.

The provider's business location address is:

102 TINDERWOOD DR
GOLDSBORO, NC
ZIP 27534-856
Phone: (919) 734-0266
Fax: (919) 734-9926

The provider's authorized official is Diane Harrison .
The authorized official title is President and has the following contact phone number (919) 734-0266.

The enumeration date for this NPI number is 1/22/2007 and was last updated on 11/2/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesMHL-096-078NORTH CAROLINANo
2311ZA0620XCustodial Care FacilityAdult Care HomeMHL-096-088NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17803548MEDICAIDNORTH CAROLINA
27803464MEDICAIDNORTH CAROLINA
37803926MEDICAIDNORTH CAROLINA
48300920MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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