Renaissance Relations, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

RENAISSANCE RELATIONS, INC

Practice address

540 McKenzie Ave
Stockbridge, GA 30281-6720

Phone

(404) 822-0946

NPI assigned

Jul 30, 2018

Last updated

Oct 22, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rasaq Sarumi

Title

Owner

Phone

(404) 822-0946

Specialties & licenses 7

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666396800000",
    "number": "1265910632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 MCKENZIE AVE",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816720",
            "telephone_number": "404-822-0946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 MCKENZIE AVE",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816720",
            "telephone_number": "404-822-0946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE RELATIONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-30",
        "last_updated": "2022-10-22",
        "certification_date": "2022-10-22",
        "status": "A",
        "authorized_official_last_name": "SARUMI",
        "authorized_official_first_name": "RASAQ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-822-0946"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "GA",
            "license": "309730029",
            "primary": false
        },
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": "GA",
            "license": "309730029",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003210772A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2022; 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.