Organization
RENAISSANCE MEDICAL GROUP, INC.
Active
Other names
Renaissance Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA SYPHAX (ADMINISTRATOR)
(301) 925-2255
Entity
Organization
Contact information
Practice address
525 EASTERN AVE, 2ND FLOOR, FAIRMOUNT HEIGHTS, MD 20743-1677
(301) 925-2255
(301) 925-2020
Mailing address
PO BOX 2966, HYATTSVILLE, MD 20784-0966
(301) 925-2255
(301) 925-2020
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
104804
MD
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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