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Organization
RENAISSANCE PRIMARY CARE, LLC
Active
Organization
RENAISSANCE PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES MANUEL PSYCHOLOGIST (PSYCHOLOGIST)
(774) 420-2311
Entity
Organization
Contact information
Practice address
11-15 SANDERSDALE ROAD, SOUTHBRIDGE, MA 01550
(774) 420-2311
(508) 519-0763
Mailing address
11-15 SANDERSDALE ROAD, SOUTHBRIDGE, MA 01550
(774) 420-2311
(508) 519-0763
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
09/27/2016
Last updated
07/15/2025
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