| Life Renewal Services, Inc. | |
|
6940 Tudsbury Rd Windsor Mill MD 21244-2674 | |
| (410) 277-8910 | |
| (410) 277-8911 |
| Full Name | Life Renewal Services, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 6940 Tudsbury Rd, Windsor Mill, Maryland |
| Authorized Official Name and Position | Karen K Byrd (CEO) |
| Authorized Official Contact | 4102778910 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Renewal Services, Inc. 6940 Tudsbury Rd Windsor Mill MD 21244-2674 Ph: (410) 277-8910 | Life Renewal Services, Inc. 6940 Tudsbury Rd Windsor Mill MD 21244-2674 Ph: (410) 277-8910 |
| NPI Number | 1124229133 |
|---|---|
| Provider Enumeration Date | 05/29/2007 |
| Last Update Date | 02/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124229133 | NPI | - | NPPES |
| 970057900 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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