| Life Renewal Services | |
|
10805 Hickory Ridge Rd Suite 103 Columbia MD 21044-3626 | |
| (443) 289-8149 | |
| (443) 821-3280 |
| Full Name | Life Renewal Services |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 10805 Hickory Ridge Rd, Columbia, Maryland |
| Authorized Official Name and Position | Karen Byrd (CEO) |
| Authorized Official Contact | 4432898149 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Renewal Services Po Box 1254 Westminster MD 21158-5254 Ph: (443) 289-8149 | Life Renewal Services 10805 Hickory Ridge Rd Suite 103 Columbia MD 21044-3626 Ph: (443) 289-8149 |
| NPI Number | 1700337698 |
|---|---|
| Provider Enumeration Date | 10/17/2016 |
| Last Update Date | 10/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700337698 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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