Renaissance Therapy Clinic Pllc

LBN: Renaissance Therapy Clinic Pllc
Renaissance Therapy Clinic Pllc is an health care organization with primary practice located at 1O West Square Lake Rd Suite 221, Bloomfield Hills MI 48302-0466. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Professional is the primary health care specialty. Renaissance Therapy Clinic Pllc can be contacted via phone (248) 990-0140, or through Vandalov, Vladimir Robert via phone (248) 990-0140.

Contact Information

Primary practice address
1O West Square Lake Rd Suite 221 Bloomfield Hills MI 48302-0466
Phone: (248) 990-0140
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Vandalov, Vladimir Robert PSYD, LPC, NCC
Phone: (248) 990-0140

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 6401005273 Michigan
Behavioral Health & Social Service Providers / Clinical 103TC0700X 6301000821 Michigan
Behavioral Health & Social Service Providers / Clinical 1041C0700X 6801069906 Michigan

Profile Details

NPI number 1407180284
LBN Legal business name Renaissance Therapy Clinic Pllc
DBA Doing business as
Authorized official Vandalov, Vladimir Robert PSYD, LPC, NCC
Entity Organization
Organization subpart 1 No
Enumeration date Sep 25th, 2009
Last updated Jul 27th, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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