NPI age
2 years
Enumerated 2024-04-08
● Active Type 2 · Organization
Subpart
Renaissance Ranch Idaho
Renaissance Ranch Idaho 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
Golesh
Administration
Last NPPES update
2024-04-08
Source: monthly bulk 2026-05
How this organization compares
Across 36 active substance abuse rehabilitation facility providers in Idaho.
NPI age
2 years
↓ 6 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2024 → 2026
2024-04Enumerated in NPPES
2024
2026
Where they practice
Primary practice location
1275 N 400 E Apt F
Rupert, ID 833508549
Mailing address
2973 W 13800 S
Bluffdale, UT 840658202
Authorized official
Elly Golesh
Administration
📞 3853210244
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Ryan Wilkinson, LMSW Counselor NPI 1467269175
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.
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Renaissance Ranch
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
Subpart of Awakening Behavioral Health.
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Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.