Provider Demographics
NPI:1215439187
Name:RNG AGENCY
Entity type:Organization
Organization Name:RNG AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CARE COORDINATION
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:813-297-8112
Mailing Address - Street 1:7853 GUNN HWY # 133
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-1611
Mailing Address - Country:US
Mailing Address - Phone:813-297-8112
Mailing Address - Fax:877-799-6786
Practice Address - Street 1:7853 GUNN HWY # 133
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-1611
Practice Address - Country:US
Practice Address - Phone:813-297-8112
Practice Address - Fax:877-799-6786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities