Organization
RENAISSANCE WELLNESS
Active
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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