Provider Demographics
NPI:1679394423
Name:RENAVIV HOME LLC
Entity type:Organization
Organization Name:RENAVIV HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:BUESO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-291-7226
Mailing Address - Street 1:12941 NORTH FWY STE 433
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-1243
Mailing Address - Country:US
Mailing Address - Phone:832-291-7226
Mailing Address - Fax:
Practice Address - Street 1:12941 NORTH FWY STE 433
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-1243
Practice Address - Country:US
Practice Address - Phone:832-291-7226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health