Provider Demographics
NPI:1861030587
Name:RENAISSANCE CASE MANAGEMENT SERVICES, LLC
Entity Type:Organization
Organization Name:RENAISSANCE CASE MANAGEMENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-528-2097
Mailing Address - Street 1:4141 SOUTHWEST FWY STE 510
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7334
Mailing Address - Country:US
Mailing Address - Phone:713-528-2097
Mailing Address - Fax:
Practice Address - Street 1:4141 SOUTHWEST FWY STE 510
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7334
Practice Address - Country:US
Practice Address - Phone:713-528-2097
Practice Address - Fax:713-960-1122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation