MEDICARE: RENEW PATH RECOVERY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1033971866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENEW PATH RECOVERY LLC

Provider Business Mailing Address
First Line	:	8118 PHILADELPHIA RD
Second Line	:
City	:	ROSEDALE
State	:	MD
Zip	:	21237-2849
Country	:	US
Telephone Number	:	310-926-6318
Fax Number	:

Provider Business Practice Location Address
First Line	:	8315 PHILADELPHIA RD
Second Line	:
City	:	ROSEDALE
State	:	MD
Zip	:	21237-2939
Country	:	US
Telephone Number	:	310-926-6318
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DANA JONES
Credential	:
Telephone Number	:	310-926-6318

Provider Enumeration Date	:	01/26/2024
Last Update Date	:	04/28/2025

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Directions to “RENEW PATH RECOVERY LLC ” Practice Location

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