Organization
RENAUD FRUITFUL LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIOMA RENAUD (EXECUTIVE DIRECTOR)
(718) 813-6711
Entity
Organization
Contact information
Practice address
3103 STONYBROOK DR, BOWIE, MD 20715-1908
(718) 813-6711
Mailing address
9564 FORT FOOTE RD, FORT WASHINGTON, MD 20744-5703
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/31/2026
Last updated
01/31/2026
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