Organization
RENEWED LIFE SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL LAKEIA BRADFORD (OWNER)
(267) 774-0240
Entity
Organization
Contact information
Practice address
5529 ARDLEIGH ST, PHILADELPHIA, PA 19138-1813
(267) 774-0240
Mailing address
5529 ARDLEIGH ST, PHILADELPHIA, PA 19138-1813
(267) 774-0240
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/25/2026
Last updated
04/25/2026
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