Provider Demographics
NPI:1386925311
Name:U.S.D. RENAISSANCE, LLC
Entity type:Organization
Organization Name:U.S.D. RENAISSANCE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:SUSANNA
Authorized Official - Last Name:DRUKER
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC- SLP
Authorized Official - Phone:956-723-5700
Mailing Address - Street 1:1020 CORPUS CHRISTI ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-5208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1020 CORPUS CHRISTI ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-5208
Practice Address - Country:US
Practice Address - Phone:956-337-4381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-04
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health