Organization
RENAISSANCE MEDICAL GROUP,INC
Active
Other names
RenaissanceTreatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA L SYPHAX (ADMINISTRATOR)
(301) 925-2255
Entity
Organization
Contact information
Practice address
525 EASTERN AVE STE B3, FAIRMOUNT HEIGHTS, MD 20743-1677
(301) 925-2255
Mailing address
PO BOX 2966, HYATTSVILLE, MD 20784-0966
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
MD
Other
Enumeration date
02/06/2007
Last updated
08/22/2020
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