Organization
RENAISSANCE MENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA DE LA CRUZ DE LA IGLESIA CBHCM (ADMINISTRATOR)
(786) 630-8663
Entity
Organization
Contact information
Practice address
18501 PINES BLVD STE 374-375, PEMBROKE PINES, FL 33029-1414
(786) 630-8663
Mailing address
18501 PINES BLVD STE 374-375, PEMBROKE PINES, FL 33029-1414
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
04/29/2021
Last updated
06/06/2024
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