| Organization Name: | RENAISSANCE RECOVERY SERVICES, LLC |
| NPI Number: | 1114175908 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SALVATORE PETRUCCI (PRESIDENT) |
| Mailing Address: | 30101 Agoura Ct Lbby 3 Agoura Hills |
| State: | CA US |
| Postal Code: | 913014300 |
| Phone Number: | 8187078102 |
| Fax Number: | 8187078111 |
| NPI Enumeration Date: | 09/04/2008 |
| NPI Last Update Date: | 09/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 324500000X |
| License Number: | 190392BP |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Substance Abuse Rehabilitation Facility |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |