| Life Renewal Services, Inc | |
|
3455 Wilkens Ave Suite 303 Baltimore MD 21229-5213 | |
| (443) 289-8149 | |
| Not Available |
| Full Name | Life Renewal Services, Inc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 3455 Wilkens Ave, Baltimore, 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, Inc Po Box 1254 Westminster MD 21158-5254 Ph: () - | Life Renewal Services, Inc 3455 Wilkens Ave Suite 303 Baltimore MD 21229-5213 Ph: (443) 289-8149 |
| NPI Number | 1427506278 |
|---|---|
| Provider Enumeration Date | 09/21/2016 |
| Last Update Date | 09/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427506278 | 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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