Renaissance Behavioral Health LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

RENAISSANCE BEHAVIORAL HEALTH LLC

Practice address

4760 S Pecos Rd Ste 203-6
Las Vegas, NV 89121-6038

Phone

(702) 930-5958

NPI assigned

Nov 6, 2018

Last updated

Jun 11, 2019By 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

Dr. Gwendolyn Terese Greene, DBH, MS, LMFTINPI 1609233329

Title

Executive Director

Phone

(702) 241-8202

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Gwendolyn Terese Greene

  • Marriage & Family Therapist
  • Henderson, NV
  • NPI 1609233329
  NPD Authorized official
• Jaylen Keysaun Green Wilson

  • Rehabilitation Practitioner
  • Las Vegas, NV
  • NPI 1659052025
  NPD (past)
• Chanda L Hazelwood

  • Rehabilitation Practitioner
  • Las Vegas, NV
  • NPI 1679854848
  NPD (past)

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1760950927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 620251",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891620251",
            "telephone_number": "702-241-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 S PECOS RD STE 203-6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891216038",
            "telephone_number": "702-930-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-06",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_middle_name": "TERESE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "702-241-8202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DBH, MS, LMFTI"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefanie D Remson, APN
• Virginia Remulta
• Kevin I Remus
• Renacer Behavior Health Group LLC
• Mary Renacia
• Renaissance Mental Health Corporation
• Renaissance Personal Care Inc.
• Renaissance Ranch Outpatient, LLC
• Lisa Renaker
• Renal Care Group Las Vegas, LLC (Fresenius Kidney Care Nevada Fire Mesa)

• Mental Health Clinic/Center (Including Community Mental Health Center) in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.