Organization
RENU RESPITE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE ROSEBORO AGCNS-BC (CLINICAL NURSE SPECIALIST)
(704) 473-6455
Entity
Organization
Contact information
Practice address
10511 ATKINS RIDGE DR, CHARLOTTE, NC 28213-4296
(704) 473-6455
Mailing address
10511 ATKINS RIDGE DR, CHARLOTTE, NC 28213-4296
(704) 473-6455
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
185443
NC
364SA2200X
Adult Health Clinical Nurse Specialist
—
—
385H00000X
Respite Care
Primary
185443
NC
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
11/22/2016
Last updated
01/03/2017
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