# RENAISSANCE RESIDENCY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356678858
- **Authorized official:** GWENDOLYN TRENESE-WILLIAMS JONES ED.S (DIRECTOR)
- **Authorized official phone:** (251) 621-3525

## Contact information

- **Practice address:** 1947 SUMMER PLACE DR W, MOBILE, AL 36618-3237
- **Practice address phone:** (251) 300-4207
- **Mailing address:** 11673 MCFARLAND RD, SPANISH FORT, AL 36527-5768
- **Mailing address phone:** (251) 621-3525
- **Mailing address fax:** (251) 621-3525

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 11/04/2009
- **Last updated:** 11/04/2009