# RENOVO WELLNESS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Renovo Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801416060
- **Authorized official:** MR. DONALD W POPE JR. (ADMINISTRATOR)
- **Authorized official phone:** (225) 256-1634

## Contact information

- **Practice address:** 10771 PERKINS RD STE C, BATON ROUGE, LA 70810-1693
- **Practice address phone:** (225) 256-1634
- **Practice address fax:** (225) 384-5402
- **Mailing address:** 10771 PERKINS RD STE C, BATON ROUGE, LA 70810-1693
- **Mailing address phone:** (225) 256-1634
- **Mailing address fax:** (225) 384-5402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 04/17/2020
- **Last updated:** 04/20/2020