Renacer Latino Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

897 Issued in IL

Legal business name

RENACER LATINO INC.

Practice address

620 Washington St
Waukegan, IL 60085-5421

Phone

(847) 336-7302

NPI assigned

Jan 18, 2008

Organization subpart

No

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

Authorized official

Name

Luz R Gvero, MISA II, CADC

Title

Exective Director

Phone

(847) 336-7302

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200614400000",
    "number": "1801072970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 WASHINGTON ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600855421",
            "telephone_number": "847-336-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 WASHINGTON ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600855421",
            "telephone_number": "847-336-7302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENACER LATINO INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-01-18",
        "status": "A",
        "authorized_official_last_name": "GVERO",
        "authorized_official_first_name": "LUZ",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECTIVE DIRECTOR",
        "authorized_official_telephone_number": "847-336-7302",
        "authorized_official_credential": "MISA II, CADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "04932522",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shirley Lachelle Razor
• Kathleen Elizabeth Ready, RD
• Daram Reddy, MD
• Michael Joseph Reed, D.C
• Markus A Reliford, RN, PMHN
• Tara Marie Renfrow, LMT
• Gregorio E Resendiz
• Jessica Revord
• Herminia Reyes
• Juliete Marie Reyes, M.S., BCBA

• Community/Behavioral Health Agency in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; 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.