MEDICARE: RENAISSANCE HEALTHCARE GROUP VIRGINIA, 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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1043950504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENAISSANCE HEALTHCARE GROUP VIRGINIA, LLC

Provider Business Mailing Address
First Line	:	720 COOL SPRINGS BLVD STE 550
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-2645
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5700 LAKE WRIGHT DR STE 409
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-1859
Country	:	US
Telephone Number	:	757-918-7976
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	SCOTT SARNACKE
Credential	:
Telephone Number	:	615-442-7689

Provider Enumeration Date	:	03/31/2022
Last Update Date	:	06/10/2026

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