# RENAISSANCE HEALTH CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Spanish Trails Rehabilitation Suites
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821536087
- **Authorized official:** KAM MCGAVOCK (PRESIDENT)
- **Authorized official phone:** (410) 773-1000

## Contact information

- **Practice address:** 1610 N RENAISSANCE BLVD NE, ALBUQUERQUE, NM 87107-7047
- **Practice address phone:** (410) 773-1000
- **Mailing address:** 1610 N RENAISSANCE BLVD NE, ALBUQUERQUE, NM 87107-7047

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 02/08/2017
- **Last updated:** 02/08/2017