Organization
RENEST RECOVERY SUPPORT SERVICES
Active
Parent organization
RENEST RECOVERY SUPPORT SERVICE, LLC
Other names
reNEST Transpo Dept
Organization subpart
Yes
Provider details
NPI number
Legal business name
RENEST RECOVERY SUPPORT SERVICE, LLC
Authorized official
THERESA ANN WADDELL MA, CADC (CHIEF ADMINISTRATIVE OFFICER)
(270) 839-6743
Entity
Organization
Contact information
Practice address
413 E DIXIE AVE STE 106, ELIZABETHTOWN, KY 42701-1162
(270) 839-6743
(270) 506-3253
Mailing address
413 E DIXIE AVE STE 106, ELIZABETHTOWN, KY 42701-1162
(270) 839-6743
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
—
—
344600000X
Taxi
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100811570
—
KY
Enumeration date
10/26/2022
Last updated
10/26/2022
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