Organization
RENAISSANCE MEDICAL GROUP, LLC
Active
Other names
Renaissance Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
JESUS D SUAREZ (OWNER/ CEO)
(774) 420-2311
Entity
Organization
Contact information
Practice address
11-15 SANDERSDALE ROAD, SOUTHBRIDGE, MA 01550-2855
(774) 420-2311
(508) 519-0763
Mailing address
11-15 SANDERSDALE ROAD, SOUTHBRIDGE, MA 01550-2855
(774) 420-2311
(508) 519-0763
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
174200000X
Meals Provider
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
333600000X
Pharmacy
—
—
342000000X
Transportation Network Company
—
—
Other
Enumeration date
08/12/2025
Last updated
08/12/2025
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