Provider Demographics
NPI:1003408188
Name:RENACER COMMUNITY WELLNESS CENTER CORP
Entity Type:Organization
Organization Name:RENACER COMMUNITY WELLNESS CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DEL C
Authorized Official - Last Name:ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-564-5282
Mailing Address - Street 1:5911 NW 173RD DR UNIT 28
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5123
Mailing Address - Country:US
Mailing Address - Phone:954-736-9161
Mailing Address - Fax:
Practice Address - Street 1:5911 NW 173RD DR UNIT 28
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5123
Practice Address - Country:US
Practice Address - Phone:786-564-5282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health