NPIMap

Organization Active NPI

Life Renewal Services

  • Adult Mental Health Clinic/Center
  • Columbia, MD
National Provider Identifier
1700337698
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
LIFE RENEWAL SERVICES
Practice address
10805 Hickory Ridge Rd
Suite 103
Columbia, MD 21044-3626
Phone
(443) 289-8149
Fax
(443) 821-3280
NPI assigned
Oct 17, 2016
Last updated
Oct 17, 2016By the provider in NPPES
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
Mrs. Karen ByrdNPI 1548755812
Title
Ceo
Phone
(443) 289-8149

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

10805 Hickory Ridge Rd
Suite 103
Columbia, MD 21044-3626

Mailing address

PO Box 1254
Westminster, MD 21158-5254
Phone (443) 289-8149

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1700337698",
    "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",
            "telephone_number": "443-289-8149",
            "fax_number": "443-821-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10805 HICKORY RIDGE RD",
            "address_2": "SUITE 103",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443626",
            "telephone_number": "443-289-8149",
            "fax_number": "443-821-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE RENEWAL SERVICES",
        "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_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, 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.