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RENAISSANCE RANCH
NPI 1063820629
Clinic/Center - Rehabilitation, Substance Use Disorder in Pocatello, ID

Active since July 28, 2014
4460 CENTRAL WAY, POCATELLO, ID 83202(208) 522-6155(208) 522-6156 Get Directions Write a Review

NPPES record last updated: July 28, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Renaissance Ranch NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RENAISSANCE RANCH (NPI 1063820629) is a healthcare organization registered as a rehabilitation, substance use disorder in Pocatello, Idaho and active in the NPI registry since July 2014. The organization lists David Pinegar, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1063820629
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameTHRONE OF GRACE, LLC.
Location Address4460 CENTRAL WAYPocatello, ID 83202-5095
Mailing Address1165 S Utah AveIdaho Falls, ID 83402-3321 · (208) 522-6155 · Fax (208) 522-6156
Phone(208) 522-6155
Fax(208) 522-6156
Organization SubpartNo
Authorized OfficialDavid PinegarExecutive Director · (208) 522-6155
Enumeration DateJuly 28, 2014
✔ NPI 1063820629 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
4460 CENTRAL WAY, Pocatello, ID 83202
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Other Names 1

Doing Business AsRenaissance Ranch

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSEPH MARTINDALE, DO,PA
Psychiatry & Neurology (Psychiatry)
4460 CENTRAL WAY, SUITE 3
CHUBBUCK, ID 83202
Bannock County (208) 237-3612
CATHY BRYDON LPC
Counselor (Mental Health)
4460 CENTRAL WAY, SUITE #2
POCATELLO, ID 83202
Bannock County (208) 237-1711
DANIELLA M MERZLOCK LPC
Counselor (Professional)
4460 CENTRAL WAY, STE 2
CHUBBUCK, ID 83202
Bannock County (208) 237-1711
DIANE WATSON MARTIN LCSW
Counselor (Mental Health)
4460 CENTRAL WAY, SUITE 2
CHUBBUCK, ID 83202
Bannock County (208) 237-1711
JOHN S HOCHHALTER LPC
Counselor (Mental Health)
4460 CENTRAL WAY, SUITE 2
CHUBBUCK, ID 83202
Bannock County (208) 237-1711
CENTER CASE MANAGEMENT AND DD SERVICES LLC
Health Maintenance Organization
4460 CENTRAL WAY, SUITE 4
CHUBBUCK, ID 83202
Bannock County (208) 237-3880
MS. WHITNEY W. HARRIS LCPC
Counselor
4460 CENTRAL WAY
CHUBBUCK, ID 83202
Bannock County (208) 237-3991
JAMES RABE NEVALA LPC
Counselor (Professional)
4460 CENTRAL WAY, SUITE 2
CHUBBUCK, ID 83202
Bannock County (208) 237-1711

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Throne Of Grace, LLC.'s NPI number?

The NPI number for Throne Of Grace, LLC. is 1063820629. It was assigned to this organization in the NPPES registry on July 28, 2014. The provider is doing business as Renaissance Ranch.

Where is Throne Of Grace, LLC. located?

Throne Of Grace, LLC. is located at 4460 Central Way, Pocatello, ID 83202. The listed phone number is (208) 522-6155.

What is Throne Of Grace, LLC.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

When was this NPI record last updated?

The NPPES record for Throne Of Grace, LLC. was last updated on July 28, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.