Provider Demographics
NPI:1225295405
Name:RENAISSANCE MANAGEMENT GROUP, INC
Entity Type:Organization
Organization Name:RENAISSANCE MANAGEMENT GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BRENDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-254-6748
Mailing Address - Street 1:7615 E 63RD PL
Mailing Address - Street 2:STE 130
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-1244
Mailing Address - Country:US
Mailing Address - Phone:918-254-6748
Mailing Address - Fax:918-254-6797
Practice Address - Street 1:7615 E 63RD PL
Practice Address - Street 2:STE 130
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-1244
Practice Address - Country:US
Practice Address - Phone:918-254-6748
Practice Address - Fax:918-254-6797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services