RENAISSANCE RANCH
NPI 1083150296
Substance Abuse Rehabilitation Facility in Meridian, ID
About Renaissance Ranch NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RENAISSANCE RANCH (NPI 1083150296) is a healthcare organization registered as a substance abuse rehabilitation facility in Meridian, Idaho and active in the NPI registry since January 2017. The organization holds a CLIA Waiver certificate valid through November 26, 2027 and lists Jason Douglas Coombs, Executive Director/owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 13D2083849
Brick House Recovery · Boise, IDOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Brick House Recovery's NPI number?
The NPI number for Brick House Recovery is 1083150296. It was assigned to this organization in the NPPES registry on January 11, 2017. The provider is doing business as Renaissance Ranch.
Where is Brick House Recovery located?
Brick House Recovery is located at 1125 E Pine Ave, Meridian, ID 83642. The listed phone number is (208) 286-4274.
What is Brick House Recovery's specialty?
The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.
Does Brick House Recovery hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 13D2083849) is associated with this NPI, valid through November 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Brick House Recovery was last updated on January 11, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Renaissance Ranch · NPI 1083150296
Substance Abuse Rehabilitation Facility organization in Meridian, Idaho. Organization record, active in the CMS NPPES registry since January 11, 2017.
## Identity
- **NPI:** 1083150296 (Entity type: Organization)
- **Enumerated:** January 11, 2017
- **Primary specialty:** Substance Abuse Rehabilitation Facility · taxonomy 324500000X
- **Legal business name:** Brick House Recovery
- **Organization subpart:** No
- **Authorized official:** Jason Coombs, EXECUTIVE DIRECTOR/OWNER
## Practice location
- **Address:** 1125 E PINE AVE, Meridian, ID 83642-5955
- **Phone:** (208) 286-4274
## Record status
- **NPPES last updated:** January 11, 2017
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1083150296) · Data from the CMS NPPES public registry.