RENAISSANCE RANCH – NPI #1083150296
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.

RENAISSANCE RANCH is a substance abuse rehabilitation facility located in MERIDIAN, ID. NPPES has assigned the NPI number 1083150296 to RENAISSANCE RANCH on January 11, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “RENAISSANCE RANCH” is a dba name, the actual legal business name for this organization is BRICK HOUSE RECOVERY. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for RENAISSANCE RANCH below.

NPI Profile for
BRICK HOUSE RECOVERY

NPI Number
1083150296
Enumeration Date

(more than 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BRICK HOUSE RECOVERY
Doing Business As (dba): RENAISSANCE RANCH
Primary location
1125 E PINE AVE
MERIDIAN, ID 83642-5955
Phone: (208) 286-4274 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JASON COOMBS
EXECUTIVE DIRECTOR/OWNER
Phone: (801) 350-1716
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
324500000X
- Substance Abuse Rehabilitation Facility (Primary)
ID
251S00000X
- Community/Behavioral Health
ID

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.