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

Renaissance Ranch Idaho

Organization Substance Abuse Rehabilitation Facility · NPI 1801649090

Renaissance Ranch Idaho is a Substance Abuse Rehabilitation Facility in Rupert, Idaho. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

1275 N 400 E Apt F
Rupert, ID 83350-8549
Phone: (801) 545-0406
Show map & directions

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

Specialties & licences

Substance Abuse Rehabilitation Facility (primary) Taxonomy 324500000X

Record details

NPI number1801649090
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationAwakening Behavioral Health
Authorized official Elly Golesh — Administration · (385) 321-0244
Other names Renaissance Ranch
NPI enumeratedApril 8, 2024
Last updated in NPPESApril 8, 2024
Certification dateApril 8, 2024
Mailing address2973 W 13800 S, Bluffdale, UT 84065-8202