Renaissance Ranch

NPI 1194169359 - Counselor - 101YA0400X

NPI Details
NPI 1194169359
Enumeration Date 04/18/2013
Last Updated 04/18/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name DAVID DAVID
Position EXECUTIVE DIRECTOR
Phone (208) 522-6155
Fax
Practice Location
1165 S UTAH AVE
IDAHO FALLS ID, 83402-3321, US
Phone (208) 522-6155
Fax
Business Location
1165 S UTAH AVE
IDAHO FALLS ID, 83402-3321, US
Phone (208) 522-6155
Fax
Toxanomy
Taxonomy Code 101YA0400X
License State
License Number
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According to our database, Renaissance Ranch NPI is 1194169359, taxonomy code is 101YA0400X Renaissance Ranch physically located at 1165 S Utah Ave, Idaho Falls ID, 83402-3321. NPI Number 1033115704 has the healthcare provider type.

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1194169359 NPI number is provided on an as is basis without warranty of any kind. 1194169359 is maintained by the National Plan & Provider Enumeration System. The contents of Renaissance Ranch are for informational purposes only.