Provider Demographics
NPI:1093401622
Name:RENAISSANCE HEALTHCARE GROUP VIRGINIA, LLC
Entity Type:Organization
Organization Name:RENAISSANCE HEALTHCARE GROUP VIRGINIA, LLC
Other - Org Name:ASTER SPRINGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SARNACKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-442-7689
Mailing Address - Street 1:2190 MANAKIN RD
Mailing Address - Street 2:
Mailing Address - City:MANAKIN SABOT
Mailing Address - State:VA
Mailing Address - Zip Code:23103-2206
Mailing Address - Country:US
Mailing Address - Phone:804-718-0946
Mailing Address - Fax:804-688-1650
Practice Address - Street 1:2190 MANAKIN RD
Practice Address - Street 2:
Practice Address - City:MANAKIN SABOT
Practice Address - State:VA
Practice Address - Zip Code:23103-2206
Practice Address - Country:US
Practice Address - Phone:804-718-0946
Practice Address - Fax:804-688-1650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-17
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility