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General NPI Number Information
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NPI Number | 1093340960
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Entity Type | Organization
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Legal Business Name | RE-NU HEALTH SERVICES, LLC.
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Dates
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Enumeration Date | 03/11/2020
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Last Update Date | 03/11/2020
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Provider Practice Location Address
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Address Line | 4330 HILLCREST DR APT 112
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City | HOLLYWOOD
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State | FL
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Zip | 33021-7934
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Country | US
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Telephone | 443-852-6376
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Fax |
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Provider Business Mailing Address
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Address Line | 4330 HILLCREST DR APT 112
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City | HOLLYWOOD
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State | FL
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Zip | 33021-7934
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Country | US
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Telephone | 443-852-6376
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. KIM SINGLETON
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Credential |
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Telephone | 410-946-4131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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