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General NPI Number Information
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NPI Number | 1851256424
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Entity Type | Organization
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Legal Business Name | RENAISSANCE HEALTHCARE GROUP VIRGINIA, LLC
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 1897 MANAKINTOWN FERRY RD
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City | MIDLOTHIAN
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State | VA
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Zip | 23113-9302
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Country | US
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Telephone | 615-864-8145
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Fax |
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Provider Business Mailing Address
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Address Line | 1039 MONTICELLO DR
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City | ANDERSON
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State | IN
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Zip | 46011-1223
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | RUSH BRADY
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Credential |
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Telephone | 615-434-2911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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