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RENAISSANCE RANCH
NPI 1104173467
Clinic/Center - Rehabilitation, Substance Use Disorder in Idaho Falls, ID

Active since August 06, 2012
1165 S UTAH AVE, IDAHO FALLS, ID 83402(208) 522-6155(208) 522-6156 Get Directions Write a Review

NPPES record last updated: December 26, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Renaissance Ranch NPPES

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

RENAISSANCE RANCH (NPI 1104173467) is a healthcare organization registered as a rehabilitation, substance use disorder in Idaho Falls, Idaho and active in the NPI registry since August 2012. The organization lists David W Pinegar, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1104173467
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameTHRONE OF GRACE, LLC.
Location Address1165 S UTAH AVEIdaho Falls, ID 83402-3321
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 W PinegarExecutive Director · (208) 522-6155
Enumeration DateAugust 6, 2012
Last NPPES UpdateDecember 26, 2012
✔ NPI 1104173467 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
1165 S UTAH AVE, Idaho Falls, ID 83402
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Other Names 1

Doing Business AsRenaissance Ranch

Other Providers at the Same Location NPPES 2

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

RENAISSANCE RANCH
Clinic/Center (Rehabilitation, Substance Use Disorder)
1165 S UTAH AVE
IDAHO FALLS, ID 83402
Bonneville County (208) 522-6155
BRIAN BUTLER MECHAM LCSW
Social Worker (Clinical)
1165 S UTAH AVE
IDAHO FALLS, ID 83402
Bonneville County (208) 522-6155

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 1104173467. It was assigned to this organization in the NPPES registry on August 6, 2012. The provider is doing business as Renaissance Ranch.

Where is Throne Of Grace, LLC. located?

Throne Of Grace, LLC. is located at 1165 S Utah Ave, Idaho Falls, ID 83402. 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 December 26, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.