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Organization

RENAISSANCE WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KIMBERLY ROYSTER PSY.D; PH.D (CEO/DIRECTOR)
(757) 782-2279
Entity
Organization

Contact information

Practice address
751 THIMBLE SHOALS BLVD STE M, NEWPORT NEWS, VA 23606-3563
(757) 782-2279
(757) 782-2313
Mailing address
751 THIMBLE SHOALS BLVD STE M, NEWPORT NEWS, VA 23606-3563
(757) 782-2279
(757) 782-2313

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
251S00000X
Community/Behavioral Health Agency
Primary
253Z00000X
In Home Supportive Care Agency

Other

Enumeration date
05/16/2019
Last updated
02/11/2020
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