Provider Demographics
NPI:1376149120
Name:RENAISSANCE HEALTHCARE GROUP RALEIGH, LLC
Entity Type:Organization
Organization Name:RENAISSANCE HEALTHCARE GROUP RALEIGH, LLC
Other - Org Name:
Other - Org Type:
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:615-864-8154
Mailing Address - Street 1:7900 TRIAD CENTER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-9076
Mailing Address - Country:US
Mailing Address - Phone:336-297-7608
Mailing Address - Fax:
Practice Address - Street 1:7900 TRIAD CENTER DR STE 300
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-9076
Practice Address - Country:US
Practice Address - Phone:336-297-7608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RENAISSANCE HEALTHCARE GROUP RALEIGH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-08
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health