| Renew Life Group, Llc | |
|
118 C-james Street Laurinburg NC 28352-4737 | |
| (910) 291-0078 | |
| Not Available |
| Full Name | Renew Life Group, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 118 C-james Street, Laurinburg, North Carolina |
| Authorized Official Name and Position | Jennetta C Rainer (OWNER) |
| Authorized Official Contact | 9102910078 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Life Group, Llc 8410 Suttonview Dr Charlotte NC 28269-5227 Ph: () - | Renew Life Group, Llc 118 C-james Street Laurinburg NC 28352-4737 Ph: (910) 291-0078 |
| NPI Number | 1003184789 |
|---|---|
| Provider Enumeration Date | 12/08/2011 |
| Last Update Date | 05/20/2016 |
| Medicare PECOS PAC ID | 7214221597 |
|---|---|
| Medicare Enrollment ID | O20160809002499 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003184789 | NPI | - | NPPES |
| Provider Name | Lindsay Brock Haywood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427481696 PECOS PAC ID: 1153665591 Enrollment ID: I20181211003844 |
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