Organization
RENEW 360 SUPPORT SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAGINA MCCLINTON (OWNER)
(704) 277-3538
Entity
Organization
Contact information
Practice address
2631 LUCENA ST, CHARLOTTE, NC 28206-2109
(704) 277-3538
(704) 277-3538
Mailing address
2631 LUCENA ST, CHARLOTTE, NC 28206-2109
(704) 277-3538
(704) 277-3538
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
225XM0800X
Mental Health Occupational Therapist
—
—
Other
Enumeration date
12/19/2025
Last updated
12/19/2025
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