RENAISSANCE RANCH IDAHO
NPI 1801649090
Substance Abuse Rehabilitation Facility in Rupert, ID

Q: What is Renaissance Ranch Idaho's NPI number?

The NPI number for Renaissance Ranch Idaho is 1801649090. It was assigned to this organization in the NPPES registry on April 8, 2024. The provider is doing business as Renaissance Ranch.

Q: What is Renaissance Ranch Idaho's specialty?

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

Active since April 08, 2024

1275 N 400 E APT F, RUPERT, ID 83350(801) 545-0406 Get Directions Write a Review

NPPES record last updated: April 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Renaissance Ranch Idaho NPPES

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

RENAISSANCE RANCH IDAHO (NPI 1801649090), doing business as Renaissance Ranch, is a healthcare organization registered as a substance abuse rehabilitation facility in Rupert, Idaho and active in the NPI registry since April 2024. The organization lists Elly Golesh, Administration, as its authorized official.

NPPES Registry Identity

NPI1801649090

Entity TypeOrganization

Primary Taxonomy324500000X

Legal Business NameRENAISSANCE RANCH IDAHO

Location Address1275 N 400 E APT FRupert, ID 83350-8549

Mailing Address2973 W 13800 SBluffdale, UT 84065-8202

Phone(801) 545-0406

Organization SubpartYesParent: Awakening Behavioral Health

Authorized OfficialElly GoleshAdministration · (385) 321-0244

Enumeration DateApril 8, 2024

NPPES CertifiedApril 8, 2024

✔ NPI 1801649090 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities

Taxonomy Code324500000X

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.

1275 N 400 E APT F, Rupert, ID 83350

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Other Names 1

Doing Business AsRenaissance Ranch

Other Providers at the Same Location NPPES

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

RYAN JAMES WILKINSON LMSW

Counselor (Mental Health)

1275 N 400 E APT F
RUPERT, ID 83350

Minidoka County (801) 228-7082

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 Idaho's NPI number?

The NPI number for Renaissance Ranch Idaho is 1801649090. It was assigned to this organization in the NPPES registry on April 8, 2024. The provider is doing business as Renaissance Ranch.

Where is Renaissance Ranch Idaho located?

Renaissance Ranch Idaho is located at 1275 N 400 E Apt F, Rupert, ID 83350. The listed phone number is (801) 545-0406.

What is Renaissance Ranch Idaho's specialty?

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

When was this NPI record last updated?

The NPPES record for Renaissance Ranch Idaho was last updated on April 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.