RENU LIFE LLC
NPI 1407055858
Custodial Care Facility - Adult Care Home in Goldsboro, NC

NPI Status: Active since July 16, 2007

Contact Information

304 S PINEVIEW AVE
GOLDSBORO, NC
ZIP 27530
Phone: (919) 734-0266
Fax: (919) 734-9926

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  • Organization
  • Custodial Care Facility
  • Adult Care Home
  • CLIA Number: 34D2030930
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 12-29-2025

About RENU LIFE LLC

This page provides the complete NPI Profile along with additional information for Renu Life Llc, a provider established in Goldsboro, North Carolina operating as a Custodial Care Facility, focusing in adult care home . The healthcare provider is registered in the NPI registry with number 1407055858 assigned on July 2007. The practitioner's primary taxonomy code is 311ZA0620X with license number MHL-096-078 (NC). The provider is registered as an organization and their NPI record was last updated 11 years ago. The authorized official of this NPI record is Mrs. Diane Harrison (President)

NPI
1407055858
Provider Name
RENU LIFE LLC
Entity Type
Organization
Location Address
304 S PINEVIEW AVE GOLDSBORO, NC 27530
Location Phone
(919) 734-0266
Location Fax
(919) 734-9926
Mailing Address
PO BOX 1017 GOLDSBORO, NC 27533
Mailing Phone
(919) 734-0266
Mailing Fax
(919) 734-9926
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-16-2007
Last Update Date
10-27-2015
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Custodial Care Facility Adult Care Home

Taxonomy Code
311ZA0620X
Type
Nursing & Custodial Care Facilities
License No.
MHL-096-078
License State
NC
Taxonomy Description
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1320600000XResidential Treatment Facilities

Residential Treatment Facility, Intellectual and/or Developmental Disabilities

HAL-096-022 (NC)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. DIANE HARRISON

Authorized Official Title
PRESIDENT
Authorized Official Phone
(919) 734-0266

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
7803379MEDICAID (05)NC 
7804269MEDICAID (05)NC 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
34D2030930
Facility Type
Assisted Living Facility
Certificate Effective Date
December 30, 2023
Certificate Expiration Date
December 29, 2025
Laboratory Director
CARI L. HARRISON CRUSE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Renu Life Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1407055858, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
0
Doubled → 0
Pos 4
7
Unchanged
Pos 5
0
Doubled → 0
Pos 6
5
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
8
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 0 → 0 5 → 10 → 1 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 0 + 7 + 0 + 5 + 1 + 0 + 8 + 1 + 0 + 24 = 52

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 52 is 60. The difference is the calculated check digit.

60 - 52 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1407055858.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Residential Treatment Facility, Intellectual and/or Developmental Disabilities
304 S PINEVIEW AVE
GOLDSBORO, NC 27530

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1407055858, enumerated as an "organization" on July 16, 2007.

The provider is located at 304 S PINEVIEW AVE GOLDSBORO, NC 27530 and the phone number is (919) 734-0266.

Custodial Care Facility with taxonomy code 311ZA0620X and a focus in Adult Care Home.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.