Organization
KILPATRICK RENAISSANCE
Active
Parent organization
RENAISSANCE SOCIAL SERVICES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
RENAISSANCE SOCIAL SERVICES, INC.
Authorized official
MICHAEL BANGHART (EXECUTIVE DIRECTOR)
(773) 645-8900
Entity
Organization
Contact information
Practice address
4655 W BERTEAU AVE, CHICAGO, IL 60641-2647
(773) 645-8900
Mailing address
2501 W WASHINGTON BLVD STE 401, CHICAGO, IL 60612-2127
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/28/2022
Last updated
01/28/2022
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