Provider Demographics
NPI:1871375048
Name:RENEWED HEALTH, L.L.C
Entity type:Organization
Organization Name:RENEWED HEALTH, L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-634-0547
Mailing Address - Street 1:6600 YORK RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-2028
Mailing Address - Country:US
Mailing Address - Phone:410-634-0547
Mailing Address - Fax:443-583-0446
Practice Address - Street 1:6600 YORK RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-2028
Practice Address - Country:US
Practice Address - Phone:410-634-0547
Practice Address - Fax:443-583-0446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health