Organization
RENAISSANCE RECOVERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN RALLIS BROWN L.C.S.W. (OWNER)
(480) 632-1345
Entity
Organization
Contact information
Practice address
459 N GILBERT RD, SUITE B140, GILBERT, AZ 85234-4591
(480) 632-1345
(480) 632-1354
Mailing address
459 N GILBERT RD, SUITE B140, GILBERT, AZ 85234-4591
(480) 632-1345
(480) 632-1354
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
Other
Enumeration date
04/24/2012
Last updated
04/06/2017
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