RENAISSANCE RANCH
NPI 1194169359
Clinic/Center - Rehabilitation, Substance Use Disorder in Idaho Falls, ID

Q: What is Renaissance Ranch's NPI number?

The NPI number for Renaissance Ranch is 1194169359. It was assigned to this organization in the NPPES registry on April 18, 2013.

Q: What is Renaissance Ranch's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Renaissance Ranch was last updated on April 18, 2013. 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.

Active since April 18, 2013

1165 S UTAH AVE, IDAHO FALLS, ID 83402(208) 522-6155 Get Directions Write a Review

NPPES record last updated: April 18, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Renaissance Ranch NPPES

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

RENAISSANCE RANCH (NPI 1194169359) is a healthcare organization registered as a rehabilitation, substance use disorder in Idaho Falls, Idaho and active in the NPI registry since April 2013. The organization lists David Pinegar, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1194169359

Entity TypeOrganization

Primary Taxonomy261QR0405X

Legal Business NameRENAISSANCE RANCH

Location Address1165 S UTAH AVEIdaho Falls, ID 83402-3321

Mailing Address1165 S Utah AveIdaho Falls, ID 83402-3321 · (208) 522-6155

Phone(208) 522-6155

Organization SubpartNo

Authorized OfficialDavid PinegarExecutive Director · (208) 522-6155

Enumeration DateApril 18, 2013

✔ NPI 1194169359 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

1165 S UTAH AVE, Idaho Falls, ID 83402

Open in Google Maps ↗

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 2

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

THRONE OF GRACE, LLC.

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 Renaissance Ranch's NPI number?

The NPI number for Renaissance Ranch is 1194169359. It was assigned to this organization in the NPPES registry on April 18, 2013.

Where is Renaissance Ranch located?

Renaissance Ranch is located at 1165 S Utah Ave, Idaho Falls, ID 83402. The listed phone number is (208) 522-6155.

What is Renaissance Ranch'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 Renaissance Ranch was last updated on April 18, 2013. 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.