Provider Demographics
NPI:1407280381
Name:RENAISSANCE ADULT DAY SERVICES-787EAST LLC
Entity Type:Organization
Organization Name:RENAISSANCE ADULT DAY SERVICES-787EAST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARENTI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:718-649-3670
Mailing Address - Street 1:787 E 156TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455-1713
Mailing Address - Country:US
Mailing Address - Phone:718-649-3670
Mailing Address - Fax:718-649-3671
Practice Address - Street 1:787 E 156TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-1713
Practice Address - Country:US
Practice Address - Phone:718-649-3670
Practice Address - Fax:718-649-3671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care