Provider Demographics
NPI:1629865043
Name:RENAISSANCE GRACE SERVICES DC LLC
Entity type:Organization
Organization Name:RENAISSANCE GRACE SERVICES DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HERVED JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMEU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-482-9712
Mailing Address - Street 1:730 24TH ST NW STE 10
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2543
Mailing Address - Country:US
Mailing Address - Phone:240-482-9712
Mailing Address - Fax:
Practice Address - Street 1:730 24TH ST NW STE 10
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2543
Practice Address - Country:US
Practice Address - Phone:240-482-9712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty