NPIMap

Organization Active NPI

Renaissance Healthcare Group Virginia, LLC

  • Adult Mental Health Clinic/Center
  • Norfolk, VA
National Provider Identifier
1043950504
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
RENAISSANCE HEALTHCARE GROUP VIRGINIA, LLC
Practice address
5700 Lake Wright Dr Ste 409
Norfolk, VA 23502-1859
Phone
(757) 918-7976
NPI assigned
Mar 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Benjamin Brady
Title
Cfo
Phone
(615) 864-8145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

5700 Lake Wright Dr Ste 409
Norfolk, VA 23502-1859

Mailing address

720 Cool Springs Blvd Ste 550
Franklin, TN 37067-2645

Other names 1

  • Pasadena Villa Outpatient- Norfolk Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Renaissance Healthcare Group Virginia LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5700 Lake Wright Dr
Ste 409
Norfolk, VA 23502
Phone (757) 918-7976

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785801600000",
    "number": "1043950504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 COOL SPRINGS BLVD STE 550",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370672645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 LAKE WRIGHT DR STE 409",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235021859",
            "telephone_number": "757-918-7976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE HEALTHCARE GROUP VIRGINIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-31",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "615-864-8145"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pasadena Villa Outpatient- Norfolk",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pasadena Villa Outpatient- Norfolk",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.