# RENU LIFE LLC

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

## Provider details

- **NPI number:** 1407055858
- **Authorized official:** MRS. DIANE HARRISON (PRESIDENT)
- **Authorized official phone:** (919) 734-0266

## Contact information

- **Practice address:** 304 S PINEVIEW AVE, GOLDSBORO, NC 27530-6037
- **Practice address phone:** (919) 734-0266
- **Practice address fax:** (919) 734-9926
- **Mailing address:** PO BOX 1017, GOLDSBORO, NC 27533-1017
- **Mailing address phone:** (919) 734-0266
- **Mailing address fax:** (919) 734-9926

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | MHL-096-078 | NC | Yes |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | HAL-096-022 | NC | — |

## Other

- **Enumeration date:** 07/16/2007
- **Last updated:** 10/27/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7803379 | — | NC |
| 05 | — | 7804269 | — | NC |