Provider Demographics
NPI:1891460374
Name:RENAY'S ANGELS PROVIDER CARE SERVICES LLC
Entity Type:Organization
Organization Name:RENAY'S ANGELS PROVIDER CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUWANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-846-9574
Mailing Address - Street 1:11007 CRINKLEAWN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77086-1406
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11007 CRINKLEAWN DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77086-1406
Practice Address - Country:US
Practice Address - Phone:832-846-9574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care