Organization
RENEWAL RETREAT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PASCHA MCCORMICK (OWNER)
(952) 297-7797
Entity
Organization
Contact information
Practice address
10845 W MONTEROSA ST, PHOENIX, AZ 85037-5754
(952) 297-7797
Mailing address
10845 W MONTEROSA ST, PHOENIX, AZ 85037-5754
(952) 297-7797
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
133V00000X
Registered Dietitian
—
—
251E00000X
Home Health Agency
—
—
Other
Enumeration date
09/01/2025
Last updated
09/01/2025
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