Organization
LIFE RENEWAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA FONTAINE (QA)
(410) 277-8910
Entity
Organization
Contact information
Practice address
247 E MAIN ST, WESTMINSTER, MD 21157-5228
(410) 277-8910
Mailing address
PO BOX 865, WESTMINSTER, MD 21158-0865
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
08/05/2013
Last updated
08/05/2013
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