Organization · Type 2 NPI

Renaissance Ranch Outpatient Treatment

Substance Abuse Rehabilitation Facility · Farmington, UT

NPI number 1700243573 Active

Practice location

1466 N Highway 89 Ste 230
Farmington, UT 84025-2738

Specialties and licenses

Taxonomy	Code	License
Substance Abuse Rehabilitation Facility Primary	324500000X	4625 (UT)

Substance Abuse Rehabilitation Facility: 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.

Another provider at this address

Therapeutic Center for Change PCClinical Social Worker Farmington, UT NPI 1720262025

NPI record

NPI: 1700243573
Entity type: Organization (Type 2)
Issued: Jan 25, 2016
Last updated: Jan 25, 2016
Status: Active
Subpart: Yes of Renaissance Ranch Outpatient Treatment

Other names

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Renaissance Ranch Outpatient - Farmington · other name

Authorized official

Cheryl Wack
Billing Manager
(801) 381-2928

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1700243573

Renaissance Ranch Outpatient Treatment's National Provider Identifier is 1700243573, issued on Jan 25, 2016. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Farmington, UT. The record was last updated on Jan 25, 2016.