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RENAISSANCE RANCH BLUFFDALE MEN'S PROGRAM
NPI 1568909117
Substance Abuse Rehabilitation Facility in Bluffdale, UT

Active since January 20, 2017CLIA 46D2130559 · Waiver
2973 W 13800 S, BLUFFDALE, UT 84065(801) 545-0406 Get Directions Write a Review

NPPES record last updated: February 2, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 2, 2017, Jan 23, 2017, Jan 20, 2017 (3 updates tracked since 2017).

About Renaissance Ranch Bluffdale Men's Program NPPES

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

RENAISSANCE RANCH BLUFFDALE MEN'S PROGRAM (NPI 1568909117) is a healthcare organization registered as a substance abuse rehabilitation facility in Bluffdale, Utah and active in the NPI registry since January 2017. The organization holds a CLIA Waiver certificate valid through May 10, 2027 and lists Wendy Patton, Administative Director, as its authorized official.

NPPES Registry Identity

NPI1568909117
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameRENAISSANCE RANCH BLUFFDALE MEN'S PROGRAM
Location Address2973 W 13800 SBluffdale, UT 84065-8202
Mailing Address2973 W 13800 SBluffdale, UT 84065-8202
Phone(801) 545-0406
Organization SubpartYesParent: Awakening Behavioral Health
Authorized OfficialWendy PattonAdministative Director · (801) 856-7836
Enumeration DateJanuary 20, 2017
Last NPPES UpdateFebruary 2, 20173 updates tracked since enumeration
✔ NPI 1568909117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Licenses✔ Licensed in UT · 26066✔ Licensed in UT · 26065
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
2973 W 13800 S, Bluffdale, UT 84065
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Utah.Insurance ›

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 46D2130559

Renaissance Ranch Bluffdale - Mens · Bluffdale, UT
Active · expires May 10, 2027
CLIA Number46D2130559
Laboratory TypeDrug Testing
Certificate Effective DateMay 11, 2025
Certificate Expiration DateMay 10, 2027
Laboratory DirectorTyson Dixon
Laboratory Phone(801) 856-7836
Laboratory LocationRenaissance Ranch Bluffdale - Mens2973 W 13800 S, Bluffdale, UT 84065
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

JACOB FERGESON
Counselor (Addiction (Substance Use Disorder))
2973 W 13800 S
BLUFFDALE, UT 84065
Salt Lake County (801) 545-0406
MR. LANE CANNON PORTER CMHC
Counselor (Mental Health)
2973 W 13800 S
BLUFFDALE, UT 84065
Salt Lake County (801) 577-4804
MATTHEW PIPER
Counselor (Addiction (Substance Use Disorder))
2973 W 13800 S
BLUFFDALE, UT 84065
Salt Lake County (801) 545-0406
AWAKENING BEHAVIORAL HEALTH, LLC
Substance Abuse Rehabilitation Facility
2973 W 13800 S
BLUFFDALE, UT 84065
Salt Lake County (801) 545-0406
BRYCE RODABOUGH
Counselor (Addiction (Substance Use Disorder))
2973 W 13800 S
BLUFFDALE, UT 84065
Salt Lake County (801) 545-0406

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 Bluffdale Men's Program's NPI number?

The NPI number for Renaissance Ranch Bluffdale Men's Program is 1568909117. It was assigned to this organization in the NPPES registry on January 20, 2017.

Where is Renaissance Ranch Bluffdale Men's Program located?

Renaissance Ranch Bluffdale Men's Program is located at 2973 W 13800 S, Bluffdale, UT 84065. The listed phone number is (801) 545-0406.

What is Renaissance Ranch Bluffdale Men's Program's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Renaissance Ranch Bluffdale Men's Program hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2130559) is associated with this NPI, valid through May 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Renaissance Ranch Bluffdale Men's Program accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Utah list Renaissance Ranch Bluffdale Men's Program as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Renaissance Ranch Bluffdale Men's Program was last updated on February 2, 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.