NPIMap

Organization Active NPI

Life Renewal Services, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Baltimore, MD
National Provider Identifier
1174074066
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
LIFE RENEWAL SERVICES, INC
Practice address
3455 Wilkens Ave
Suite 303
Baltimore, MD 21229-5213
Phone
(443) 289-8149
NPI assigned
Oct 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Authorized official

Name
Karen Byrd, LCPC
Title
Ceo
Phone
(443) 289-8149

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

3455 Wilkens Ave
Suite 303
Baltimore, MD 21229-5213

Mailing address

PO Box 1254
Westminster, MD 21158-5254

National Provider Directory

National Provider Directory
Tax ID family
Life Renewal Services Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

3455 Wilkens Ave
Ste 303
Baltimore, MD 21229
Phone (410) 525-1105

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476662400000",
    "number": "1174074066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1254",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211585254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 WILKENS AVE",
            "address_2": "SUITE 303",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295213",
            "telephone_number": "443-289-8149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE RENEWAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-289-8149",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.