Organization
RENAISSANCE FAMILY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELIJAH SHARP (CEO)
(757) 966-1130
Entity
Organization
Contact information
Practice address
702 HANCOCK AVE, PORTSMOUTH, VA 23701-3345
(757) 966-1130
Mailing address
702 HANCOCK AVE, PORTSMOUTH, VA 23701-3345
(757) 966-1130
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
1723
VA
Other
Enumeration date
09/17/2012
Last updated
09/17/2012
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