Healthcare Provider Details

I. General information

NPI: 1306265715
Provider Name (Legal Business Name): RENEWED INTERVENTIONS L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2014
Last Update Date: 04/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 YORK ST
HAMPTON VA
23661-1455
US

IV. Provider business mailing address

15 YORK ST
HAMPTON VA
23661-1455
US

V. Phone/Fax

Practice location:
  • Phone: 757-234-1418
  • Fax:
Mailing address:
  • Phone: 757-234-1418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MRS. KELLY ROBINSON LEE
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 757-234-1418