Provider Demographics
NPI:1821815135
Name:RELAX RELIGHT RENEW
Entity type:Organization
Organization Name:RELAX RELIGHT RENEW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRINCA-PIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-483-7465
Mailing Address - Street 1:702 SW 122ND AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-5921
Mailing Address - Country:US
Mailing Address - Phone:954-483-7465
Mailing Address - Fax:321-452-2802
Practice Address - Street 1:7777 N WICKHAM RD STE 12-224
Practice Address - Street 2:
Practice Address - City:VIERA
Practice Address - State:FL
Practice Address - Zip Code:32940-7976
Practice Address - Country:US
Practice Address - Phone:321-223-8003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No251S00000XAgenciesCommunity/Behavioral Health