| NPI | 1083150296 |
|---|---|
| Doing Business As | RENAISSANCE RANCH |
| Entity Type | Organization |
| Authorized Contact | JASON DOUGLAS COOMBS Executive Director/Owner 801-350-1716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2017-01-11 |