# RENAISSANCE MENTAL LLC

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

## Provider details

- **NPI number:** 1407439383
- **Authorized official:** MELISSA DE LA CRUZ DE LA IGLESIA CBHCM (ADMINISTRATOR)
- **Authorized official phone:** (786) 630-8663

## Contact information

- **Practice address:** 18501 PINES BLVD STE 374-375, PEMBROKE PINES, FL 33029-1414
- **Practice address phone:** (786) 630-8663
- **Mailing address:** 18501 PINES BLVD STE 374-375, PEMBROKE PINES, FL 33029-1414

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | NULL | — |
| 103K00000X | Behavior Analyst | — | — | — |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/29/2021
- **Last updated:** 06/06/2024