Renewed Life Residence LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

RENEWED LIFE RESIDENCE LLC

Practice address

8504 Terra Cota LN
Fort Worth, TX 76123-2934

Phone

(817) 805-0702

NPI assigned

Jul 27, 2026

Last updated

Jul 27, 2026By 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

Harriett Wilson

Title

Managing Partner

Phone

(817) 805-0702

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1785110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785110400000",
    "number": "1831011634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8504 TERRA COTA LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761232934",
            "telephone_number": "817-805-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8504 TERRA COTA LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761232934",
            "telephone_number": "817-805-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWED LIFE RESIDENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-27",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-26",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "HARRIETT",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "817-805-0702"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Rendon, LPC
• Ashley Nicole Reneau, PT, DPT
• Renew Physical Therapy Fort Worth PLLC
• Renew Toxicology
• Renew Weight Loss Marketing LLC (Renew DFW)
• Amanda Flory Renfro, PT, DPT
• Janet Renfro, RN
• Ashley Brooke Rennels, M.S. CCC-SLP
• Monica Reno, CNM
• Theresa Reno, MD PHD

• Community/Behavioral Health Agency in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Community/Behavioral Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.