Provider Demographics
NPI:1609149509
Name:RENEWLIFE HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:RENEWLIFE HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-360-7095
Mailing Address - Street 1:8411 WEST BELLFORT ST.
Mailing Address - Street 2:SUITE 110B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-2205
Mailing Address - Country:US
Mailing Address - Phone:713-360-7095
Mailing Address - Fax:713-360-7160
Practice Address - Street 1:8411 W BELLFORT ST
Practice Address - Street 2:SUITE 110B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-2205
Practice Address - Country:US
Practice Address - Phone:713-360-7095
Practice Address - Fax:713-360-7160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)