Provider Demographics
NPI:1336265743
Name:RENEWAL CENTERS INC
Entity type:Organization
Organization Name:RENEWAL CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PORRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-791-9974
Mailing Address - Street 1:PO BOX 35762
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85740-5762
Mailing Address - Country:US
Mailing Address - Phone:520-791-9974
Mailing Address - Fax:520-791-0676
Practice Address - Street 1:6700 N ORACLE RD STE 505
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7736
Practice Address - Country:US
Practice Address - Phone:520-791-9974
Practice Address - Fax:520-791-0676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC10653101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ136163Medicare PIN