Organization
RENOVA CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROMAN J. SHAHAY (DIRECTOR)
(717) 274-0493
Entity
Organization
Contact information
Practice address
25 METRO DR, LEBANON, PA 17042-9172
(717) 274-0493
(717) 274-2574
Mailing address
25 METRO DR, LEBANON, PA 17042-9172
(717) 274-0493
(717) 274-2574
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
76404078
PA
Other
Enumeration date
03/06/2007
Last updated
08/22/2020
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