| Renew Residential Services Llc | |
|
2508 Demington Ave Nw Canton OH 44708-2446 | |
| (330) 575-2055 | |
| Not Available |
| Full Name | Renew Residential Services Llc |
|---|---|
| Speciality | In Home Supportive Care |
| Location | 2508 Demington Ave Nw, Canton, Ohio |
| Authorized Official Name and Position | Nicholas Carreon (CEO) |
| Authorized Official Contact | 3305752055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Residential Services Llc 8109 Diamond Park Ave Ne Canton OH 44721-7506 Ph: (330) 575-2055 | Renew Residential Services Llc 2508 Demington Ave Nw Canton OH 44708-2446 Ph: (330) 575-2055 |
| NPI Number | 1194463422 |
|---|---|
| Provider Enumeration Date | 05/25/2022 |
| Last Update Date | 05/26/2022 |
| Certification Date | 05/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194463422 | NPI | - | NPPES |
| 0472182 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 253Z00000X | In Home Supportive Care | (* (Not Available)) | Primary |
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