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NPI Code Detail

MEDICARE: RENEW CONSTRUCTION GOUP LLC

MEDICARE: RENEW CONSTRUCTION GOUP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224ZR0403XDriving and Community Mobility Occupational Therapy Assistant
2251C00000XDevelopmentally Disabled Services Day Training Agency
3251J00000XNursing Care Agency
4251S00000XCommunity/Behavioral Health Agency
5253J00000XFoster Care Agency
6253Z00000XIn Home Supportive Care Agency
7310400000XAssisted Living Facility
8322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility
9324500000XSubstance Abuse Rehabilitation Facility
103245S0500XChildren's Substance Abuse Rehabilitation Facility
11320600000XIntellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number : 1013791870
Entity Type Code : Organization
Provider Name (Legal Business Name) : RENEW CONSTRUCTION GOUP LLC
Provider Business Mailing Address
First Line : 848 N RAINBOW BLVD # 9142
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-1103
Country : US
Telephone Number : 702-857-7536
Fax Number :
Provider Business Practice Location Address
First Line : 4225 TIMPANI DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-2247
Country : US
Telephone Number : 702-857-7536
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DAN S DAVID
Credential : HOUSING PROVIDER
Telephone Number : 702-857-7536
Provider Enumeration Date : 08/23/2023
Last Update Date : 08/23/2023

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Directions to “RENEW CONSTRUCTION GOUP LLC ” Practice Location

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