Provider Demographics
NPI:1962143008
Name:AMERICAN RENAISSANCE SCHOOL
Entity type:Organization
Organization Name:AMERICAN RENAISSANCE SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXCEPTIONAL CHILDREN'S DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RECTOR
Authorized Official - Suffix:
Authorized Official - Credentials:ED
Authorized Official - Phone:704-924-8870
Mailing Address - Street 1:132 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-5852
Mailing Address - Country:US
Mailing Address - Phone:704-924-8870
Mailing Address - Fax:
Practice Address - Street 1:132 E BROAD ST
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-5852
Practice Address - Country:US
Practice Address - Phone:704-924-8870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
No163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Multi-Specialty