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Organization
RENOVIS HEALTH LLC
Active
Organization
RENOVIS HEALTH LLC
Active
Other names
Renovis Health
Organization subpart
No
Provider details
NPI number
Authorized official
OLISAELOKA DALLAH (CHIEF ADMINISTRATIVE OFFICER)
(248) 470-7318
Entity
Organization
Contact information
Practice address
26206 W 12 MILE RD STE 302, SOUTHFIELD, MI 48034-8501
(424) 303-0544
Mailing address
29155 NORTHWESTERN HWY # 515, SOUTHFIELD, MI 48034-1011
(800) 960-1463
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
251E00000X
Home Health Agency
—
—
302R00000X
Health Maintenance Organization
—
—
Other
Enumeration date
09/30/2020
Last updated
03/13/2023
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