Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Renaissance Ranch

Organization Addiction (Substance Use Disorder) Counselor · NPI 1194169359

Renaissance Ranch is an Addiction (Substance Use Disorder) Counselor in Idaho Falls, Idaho. Registered with an NPI since 2013.

In the registry since
2013
Specialties on file
3

Practice location Address checks out

1165 S Utah Ave
Idaho Falls, ID 83402-3321
Phone: (208) 522-6155
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Substance Use Disorder Rehabilitation Clinic/Center (primary) Taxonomy 261QR0405X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1194169359
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official David Pinegar — Executive Director · (208) 522-6155
NPI enumeratedApril 18, 2013
Last updated in NPPESApril 18, 2013
Mailing address1165 S Utah Ave, Idaho Falls, ID 83402-3321

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