Provider Demographics
NPI:1043607039
Name:RENATUS CARE LLC
Entity Type:Organization
Organization Name:RENATUS CARE LLC
Other - Org Name:PROVISTA HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-965-0431
Mailing Address - Street 1:4849 GREENVILLE AVE
Mailing Address - Street 2:SUITE 1125
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206
Mailing Address - Country:US
Mailing Address - Phone:214-299-8566
Mailing Address - Fax:214-299-5136
Practice Address - Street 1:4849 GREENVILLE AVE
Practice Address - Street 2:SUITE 1125
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206
Practice Address - Country:US
Practice Address - Phone:214-965-0431
Practice Address - Fax:214-965-0434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based