Organization
RENAISSANCE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BILLY CANNON (DIRECTOR OF BUSINESS DEVELOPMENT)
(313) 551-3534
Entity
Organization
Contact information
Practice address
5250 JOHN R ST, DETROIT, MI 48202-4030
(313) 831-1911
(313) 831-1931
Mailing address
5250 JOHN R ST, DETROIT, MI 48202-4030
(313) 831-1911
(313) 831-1931
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
823125
MI
Other
Enumeration date
11/29/2010
Last updated
11/29/2010
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