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Contact Information

RENAISSANCE PRIMARY CARE, LLC
11-15 SANDERSDALE ROAD
SOUTHBRIDGE, MA01550
 Phone: 774-420-2311
 Fax: 508-519-0763
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Mental Health

101YM0800X
 

Primary Care

261QP2300X
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for RENAISSANCE PRIMARY CARE, LLC

NPI # 1649729021
LBN Legal business name RENAISSANCE PRIMARY CARE, LLC
Authorized official JAMES MANUEL - (PSYCHOLOGIST)
Entity Organization
Organization subpart 1 No
Enumeration date 09/27/2016
Last updated 07/15/2025 - About 11 months 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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