NPI age
4 years
Enumerated 2021-08-10
● Active Type 2 · Organization
Renaissance Ranch Heyburn
Renaissance Ranch Heyburn is 1 of 36 substance abuse rehabilitation facility organizations in Idaho.
Primary specialty
Substance Abuse Rehabilitation Facility
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Dixon
Owner
Last NPPES update
2021-08-10
Source: monthly bulk 2026-05
How this organization compares
Across 36 active substance abuse rehabilitation facility providers in Idaho.
NPI age
4 years
↓ 4 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2021 → 2026
2021-08Enumerated in NPPES
2021
2026
Where they practice
Primary practice location
312 S 950 W
Heyburn, ID 833369765
Mailing address
312 S 950 W
Heyburn, ID 833369765
Authorized official
Tyson Blaine Dixon
Owner
📞 8018600118
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Casey Smith, FNPC Nurse Practitioner NPI 1023524196
Specialties
-
Substance Abuse Rehabilitation Facility PrimaryA 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.
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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