MEDICARE: RENEW PROJECT 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	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1467387266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENEW PROJECT LLC

Provider Business Mailing Address
First Line	:	12921 LONGSTRAW RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28227-3687
Country	:	US
Telephone Number	:	704-506-8064
Fax Number	:

Provider Business Practice Location Address
First Line	:	12921 LONGSTRAW RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28227-3687
Country	:	US
Telephone Number	:	704-506-8064
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAIMYIAH DAVIDA DRAPER
Credential	:
Telephone Number	:	704-506-8064

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

Similar Medicare Providers

1972473585 — TRANSFORM U INSTITUTE LLC
Practice Location Address:

12921 LONGSTRAW RD
CHARLOTTE, NC
28227-3687

Practice Phone: 704-506-8064
Practice Fax:

1679408066 — KIRSTYN GIBSON
Practice Location Address:

8509 CROWN CRESCENT CT
CHARLOTTE, NC
28227-7733

Practice Phone: 706-842-5330
Practice Fax: 706-842-5340

1942135264 — CANDICE POLK
Practice Location Address:

2301 CROWNPOINT EXECUTIVE DR UNIT J
CHARLOTTE, NC
28227-7824

Practice Phone: 704-619-7060
Practice Fax:

1083540173 — STEPHANIE BEHUNIAK
Practice Location Address:

6418 SNOW BIRD LN
CHARLOTTE, NC
28227-2496

Practice Phone: 603-443-1343
Practice Fax:

1902328461 — KERBY DEJESUS BCBA, M. ED
Practice Location Address:

7504 E INDEPENDENCE BLVD STE 103
CHARLOTTE, NC
28227-9407

Practice Phone: 888-392-8642
Practice Fax:

1639001068 — EIRWYN BERES
Practice Location Address:

8509 CROWN CRESCENT CT
CHARLOTTE, NC
28227-7733

Practice Phone: 706-842-5330
Practice Fax: 706-842-5340

Directions to “RENEW PROJECT LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.