Renaissance Recovery Services, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

190392AP Issued in CA

Legal business name

RENAISSANCE RECOVERY SERVICES, LLC

Practice address

30101 Agoura CT Lbby 3
Agoura Hills, CA 91301-4300

Phone

(818) 707-8102

Fax

(818) 707-8111

NPI assigned

Sep 4, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Salvatore Petrucci

Title

President

Phone

(818) 707-8102

Specialties & licenses 2

Addresses

Other names 1

• Renaissance Malibu Doing business as

Locations

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220486400000",
    "number": "1114175908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30765 PACIFIC COAST HWY # 356",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902653646",
            "telephone_number": "818-707-8102",
            "fax_number": "818-707-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30101 AGOURA CT LBBY 3",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014300",
            "telephone_number": "818-707-8102",
            "fax_number": "818-707-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE RECOVERY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-04",
        "status": "A",
        "authorized_official_last_name": "PETRUCCI",
        "authorized_official_first_name": "SALVATORE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-707-8102",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190392AP",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190392BP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renaissance Malibu",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in Agoura Hills, CA
• Providers in Agoura Hills, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; 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.