Organization
RENEWED COMMUNITY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEMITRIC WHITE (COO)
(804) 481-1977
Entity
Organization
Contact information
Practice address
4846 DAHLIA TER, SAN ANTONIO, TX 78218-2731
(804) 481-1977
Mailing address
4846 DAHLIA TER, SAN ANTONIO, TX 78218-2731
(804) 481-1977
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
07/11/2023
Last updated
08/07/2023
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