Provider Demographics
NPI:1538324801
Name:RENASSAINCE RETIREMENT CENTER, LLC
Entity Type:Organization
Organization Name:RENASSAINCE RETIREMENT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DELILAH
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-323-7306
Mailing Address - Street 1:300 W AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-8000
Mailing Address - Country:US
Mailing Address - Phone:407-323-7306
Mailing Address - Fax:407-323-7336
Practice Address - Street 1:300 W AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-8000
Practice Address - Country:US
Practice Address - Phone:407-323-7306
Practice Address - Fax:407-323-7336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL05815310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility