Provider Demographics
NPI:1316608987
Name:RENOWNED CARE LLC
Entity type:Organization
Organization Name:RENOWNED CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ADEDEJI
Authorized Official - Middle Name:
Authorized Official - Last Name:OWOLABI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-384-9606
Mailing Address - Street 1:1325 MILLS COVE DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-6738
Mailing Address - Country:US
Mailing Address - Phone:404-384-9606
Mailing Address - Fax:
Practice Address - Street 1:1325 MILLS COVE DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-6738
Practice Address - Country:US
Practice Address - Phone:404-384-9606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health