# LIFE RENEWAL SERVICES, INC.

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

## Provider details

- **NPI number:** 1841622586
- **Authorized official:** LISA FONTAINE (QA)
- **Authorized official phone:** (410) 277-8910

## Contact information

- **Practice address:** 247 E MAIN ST, WESTMINSTER, MD 21157-5228
- **Practice address phone:** (410) 277-8910
- **Mailing address:** PO BOX 865, WESTMINSTER, MD 21158-0865

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | — | NULL | Yes |

## Other

- **Enumeration date:** 08/05/2013
- **Last updated:** 08/05/2013