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Contact Information

RENEW LIFE GROUP, LLC
118 C-JAMES STREET
LAURINBURG, NC28352-4737
 Phone: 910-291-0078
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
 

Addiction (Substance Use Disorder)

101YA0400X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Counselor

101Y00000X
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Mental Health

101YM0800X
 

Prescribing (Medical)

103TP0016X 62 Psychologist, Clinical
 

Professional

101YP2500X
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for RENEW LIFE GROUP, LLC

NPI # 1003184789
LBN Legal business name RENEW LIFE GROUP, LLC
Authorized official JENNETTA RAINER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/08/2011
Last updated 05/20/2016 - About 10 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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