Organization
RENAISSANCE SOCIAL SERVICES, INC.
Active
Other names
Renaissance Social Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BANGHART M.A., L.P.C. (EXECUTIVE DIRECTOR)
(773) 645-8900
Entity
Organization
Contact information
Practice address
2501 W WASHINGTON BLVD STE 401, CHICAGO, IL 60612-2127
(773) 645-8900
(312) 624-9849
Mailing address
2501 W WASHINGTON BLVD STE 401, CHICAGO, IL 60612-2127
(773) 645-8900
(312) 624-9849
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000015006
—
IL
Enumeration date
04/11/2007
Last updated
01/28/2022
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