| NPI | 1063820629 |
|---|---|
| Doing Business As | RENAISSANCE RANCH |
| Entity Type | Organization |
| Authorized Contact | DAVID PINEGAR Executive Director 208-522-6155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2014-07-28 |