NPIMap

Organization Active NPI

Renaissance Recovery

  • Substance Abuse Rehabilitation Facility
  • Detroit, MI
National Provider Identifier
1396047239
Registry record updated Nov 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
823125 Issued in MI
Legal business name
RENAISSANCE RECOVERY
Practice address
5250 John R St
Detroit, MI 48202-4030
Phone
(313) 831-1911
Fax
(313) 831-1931
NPI assigned
Nov 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2010

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

Authorized official

Name
Billy Cannon
Title
Director of Business Development
Phone
(313) 551-3534

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 823125 MI Primary

Addresses

Primary practice location

5250 John R St
Detroit, MI 48202-4030

Mailing address

5250 John R St
Detroit, MI 48202-4030
Phone (313) 831-1911

National Provider Directory

National Provider Directory

Locations

5250 John R St
Detroit, MI 48202
Phone (313) 831-1911

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290988800000",
    "number": "1396047239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482024030",
            "telephone_number": "313-831-1911",
            "fax_number": "313-831-1931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482024030",
            "telephone_number": "313-831-1911",
            "fax_number": "313-831-1931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-29",
        "last_updated": "2010-11-29",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "BILLY",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "313-551-3534"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MI",
            "license": "823125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; 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.