Provider Demographics
NPI:1689996241
Name:RENEWED LIVING LLC
Entity Type:Organization
Organization Name:RENEWED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOME HEALTH CARE
Authorized Official - Prefix:MRS
Authorized Official - First Name:SEBRINA
Authorized Official - Middle Name:AVA
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-557-0209
Mailing Address - Street 1:17585 SUNNYBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:LATHRUP VILLAGE
Mailing Address - State:MI
Mailing Address - Zip Code:48076-3510
Mailing Address - Country:US
Mailing Address - Phone:248-557-0209
Mailing Address - Fax:
Practice Address - Street 1:17585 SUNNYBROOK AVE
Practice Address - Street 2:
Practice Address - City:LATHRUP VILLAGE
Practice Address - State:MI
Practice Address - Zip Code:48076-3510
Practice Address - Country:US
Practice Address - Phone:248-557-0209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty