Healthcare Provider Details

I. General information

NPI: 1417867433
Provider Name (Legal Business Name): RENEW PATH RECOVERY LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25538 MAIER CIR
MENIFEE CA
92585-8881
US

IV. Provider business mailing address

6300 CANOGA AVE STE 1320
WOODLAND HILLS CA
91367-8008
US

V. Phone/Fax

Practice location:
  • Phone: 818-918-5511
  • Fax:
Mailing address:
  • Phone: 818-918-5511
  • Fax: 323-417-4789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DANA JONES
Title or Position: CEO
Credential:
Phone: 310-926-6318