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Organization
RENATA B STURDIVANT
Active
Organization
RENATA B STURDIVANT
Active
Other names
Regional Wellness Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RENATA STURDIVANT B.S., RRT (SOLE PROPRIETOR)
(309) 258-1194
Entity
Organization
Contact information
Practice address
7503 RIVERSIDE PARK DR, SAN ANTONIO, TX 78249-4324
(309) 258-1194
Mailing address
3516 W MARY KNOLL CT, PEORIA, IL 61615-3727
(309) 258-1194
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
NULL
311ZA0620X
Adult Care Home Facility
—
NULL
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
NULL
Other
Enumeration date
02/18/2011
Last updated
02/19/2011
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