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Organization

RENAISSANCE SUPPORTIVE SERVICES INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LATRESE CURRY HARRISON (OWNER)
(904) 786-6486
Entity
Organization

Contact information

Practice address
10213 RISING MIST LN, JACKSONVILLE, FL 32221-3006
(904) 786-6486
Mailing address
10213 RISING MIST LN, JACKSONVILLE, FL 32221-3006
(904) 786-6486

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
690575796
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
690575796
FL
Enumeration date
12/03/2008
Last updated
12/03/2008
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