Healthcare Provider Details

I. General information

NPI: 1801740261
Provider Name (Legal Business Name): RENOVA SURGICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2243 E 12 MILE RD STE B
WARREN MI
48092-5644
US

IV. Provider business mailing address

2243 E 12 MILE RD STE B
WARREN MI
48092-5644
US

V. Phone/Fax

Practice location:
  • Phone: 586-573-8100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JESSICA SORSBY SCHLEMBACH
Title or Position: VP OF OPERATIONS
Credential:
Phone: 636-980-6500