RENAISSANCE RECOVERY LLC NPI 1891216511

NPI Information

NPI: 1891216511
Provider Name: RENAISSANCE RECOVERY, LLC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
10175 SLATER AVENUE SUITE 111
FOUNTAIN VALLEY, CA
ZIP 92708
Phone: (203) 450-8824
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RENAISSANCE RECOVERY, LLC is a substance abuse rehabilitation facility in Fountain Valley, CA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. RENAISSANCE RECOVERY, LLC NPI is 1891216511. The provider is registered as an organization entity type.

The provider's business location address is:

10175 SLATER AVENUE SUITE 111
FOUNTAIN VALLEY, CA
ZIP 92708-270
Phone: (203) 450-8824

The provider's authorized official is John Petti .
The authorized official title is Ceo and has the following contact phone number (949) 397-6095.

The enumeration date for this NPI number is 7/3/2017 and was last updated on 10/16/2017.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility				Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	201716410068	OTHER	CALIFORNIA	OUT OF NETWORK INSURANCE

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: 4/28/2024

NPI Synchronization or Removal

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