Organization
RENEW LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MONIQUE EVANGELINE LACROIX (CEO)
(757) 715-2117
Entity
Organization
Contact information
Practice address
11815 FOUNTAIN WAY STE 300, NEWPORT NEWS, VA 23606-4448
(757) 715-2117
Mailing address
11815 FOUNTAIN WAY STE 300, NEWPORT NEWS, VA 23606-4448
(757) 715-2117
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
382319-13
VA
Other
Enumeration date
02/06/2014
Last updated
02/06/2014
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