NPI Code Detail JSON Logo

1124922570 NPI number — RENOVO THERAPY PLLC

NPI Number: 1124922570
Health Care Provider/Practitioner: RENOVO THERAPY PLLC

Information about “1124922570” NPI (RENOVO THERAPY PLLC) exists in 1124922570 in HTML format HTML  |  1124922570 in plain Text format TXT  |  1124922570 in PDF (Portable Document Format) PDF  |  1124922570 in an XML format XML  formats.

NPI Number : 1124922570 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124922570",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "RENOVO THERAPY PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2125 W 32ND AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DENVER",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80211-3458",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "720-608-1197",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "190 E 9TH AVE STE 552",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DENVER",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80203-2744",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "720-608-1197",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/07/2026",
    "LastUpdateDate": "10/07/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ROTTINGER",
    "AuthorizedOfficialFirstName": "REBECCA",
    "AuthorizedOfficialMiddleName": "ANN",
    "AuthorizedOfficialTitle": "OWNER/THERAPIST",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LCSW",
    "AuthorizedOfficialTelephoneNumber": "720-608-1197",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QM0801X",
        "TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
        "LicenseNumber": null,
        "LicenseNumberStateCode": "NULL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.