Healthcare Provider Details

I. General information

NPI: 1609149509
Provider Name (Legal Business Name): RENEWLIFE HEALTH CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2012
Last Update Date: 02/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8411 W BELLFORT ST SUITE 110B
HOUSTON TX
77071-2205
US

IV. Provider business mailing address

8411 WEST BELLFORT ST. SUITE 110B
HOUSTON TX
77071-2205
US

V. Phone/Fax

Practice location:
  • Phone: 713-360-7095
  • Fax: 713-360-7160
Mailing address:
  • Phone: 713-360-7095
  • Fax: 713-360-7160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. GLORIA FRANCIS
Title or Position: EXECUTIVE PROGRAM DIRECTOR
Credential:
Phone: 713-360-7095