| Organization Name: | THE RENAISSANCE PROJECT INC PORT CHESTER |
| NPI Number: | 1083910392 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAULA PRESTON (OFFICE MGR.) |
| Mailing Address: | 132 Pearl St Port Chester |
| State: | NY US |
| Postal Code: | 105737614 |
| Phone Number: | 9149392700 |
| Fax Number: | 9149395352 |
| NPI Enumeration Date: | 02/03/2011 |
| NPI Last Update Date: | 02/03/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | 130211068 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |