Provider Demographics
NPI:1932830957
Name:RENAISSANCE HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:RENAISSANCE HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GENEVIEVE
Authorized Official - Middle Name:KATE
Authorized Official - Last Name:KEYTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:571-466-8557
Mailing Address - Street 1:2121 EISENHOWER AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4688
Mailing Address - Country:US
Mailing Address - Phone:571-466-8557
Mailing Address - Fax:703-684-3620
Practice Address - Street 1:2121 EISENHOWER AVE STE 200
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4688
Practice Address - Country:US
Practice Address - Phone:571-466-8557
Practice Address - Fax:703-684-3620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No253Z00000XAgenciesIn Home Supportive Care