RENAISSANCE RECOVERY RESOURCES, INC. (NPI# 1063074359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063074359 |
| Entity Type | Organization |
| Organization Name | RENAISSANCE RECOVERY RESOURCES, INC. |
| Practice Address |
1184 Mcgee Ct Ne Ste 200 Keizer OR 97303-9443 |
| Mailing Address |
Po Box 20674 Keizer OR 97307-0674 |
| Practice Telephone | 5033044358 |
| Practice Fax Number | 5033044361 |
| Mailing Telephone | 5033044352 |
| Mailing Fax Number | 5033044361 |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2019-07-08 |
| Authorized Official Name | JUSTIN SCOTT NIELSEN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5033044358 |
| Authorized Official Credential | CADC II |
| Is Organization Subpart | Y |
| Parent Organization Name | RENAISSANCE RECOVERY RESOURCES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Oregon Recovery Behavioral Health | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 465 Commercial St Ne Ste 150, Salem, OR 973013414 | 5033622780 | 5033622780 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639125156 | Renaissance Recovery Resources, Inc. | Counselor | 1184 Mcgee Ct Ne, Suite 200, Keizer, OR 97303 | 2006-05-26 |
| Street Address |
1184 MCGEE CT NE STE 200 |
| City | KEIZER |
| State | OR |
| Zip Code | 97303-9443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548822216 | Oregon Recovery Behavioral Health | Substance Abuse Rehabilitation Facility | 1184 Mcgee Ct Ne Ste 200, Keizer, OR 97303-9443 | 2019-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649750175 | Kristin Marie Barz | Behavioral Analyst | 4690 12th Ave Ne, Keizer, OR 97303 | 2018-08-15 |
| 1003359605 | Angela Rose Richard | Community Health Worker | 3410 Cherry Avenue Ne, Keizer, OR 97303 | 2016-11-30 |
| 1881146629 | Alma Denise Vera | Dental Hygienist | 5825 Shoreview Lane Ste C, Keizer, OR 97303 | 2016-10-27 |
| 1679919849 | Ramya Shyamala Kamath | Dentist | 4817 River Rd N, Keizer, OR 97303 | 2013-05-15 |
| 1356682041 | Teresa M Treinen | Physical Therapist | 190 Sandy Drive N, Keizer, OR 97303 | 2013-03-06 |
| 1598001844 | Eagle Eye Vision Care LLC | Optometrist | 4048 River Road North, Keizer, OR 97303 | 2012-12-13 |
| 1245590553 | Thora Jane Stacy | Dental Assistant | 2300 N.e. Lacncaster Dr., Salem, OR 97303 | 2012-05-21 |
| 1295028850 | Rodger Nordskog Magnuson | Pharmacist | 5452 River Road N., Keizer, OR 97303 | 2011-05-16 |
| 1326299843 | Douglas Scott Hamblin | Pediatrics | 5685 Inland Shores Way, Keizer, OR 97303 | 2008-10-02 |
| 1982870382 | Debra Kaye Lynch | Podiatrist | 4905 River Road N, Keizer, OR 97303 | 2008-05-06 |
| Find all providers in zip 97303 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A 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. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548822216 | Oregon Recovery Behavioral Health | Substance Abuse Rehabilitation Facility | 1184 Mcgee Ct Ne Ste 200, Keizer, OR 97303-9443 | 2019-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669000865 | Mid-valley Healthcare, Inc. | Substance Abuse Rehabilitation Facility | 111 N Main St Ste B, Lebanon, OR 97355-2869 | 2020-04-01 |
| 1972011682 | Women's Enrichment Counseling | Substance Abuse Rehabilitation Facility | 1300 John Adams St Ste 103, Oregon City, OR 97045-1691 | 2018-01-16 |
| 1356851042 | Debra Monaghan | Substance Abuse Rehabilitation Facility | 1271 Sw 9th St, Warrenton, OR 97146-9418 | 2017-10-06 |
| 1619429396 | Serenity Lane | Substance Abuse Rehabilitation Facility | 304 Dartmoor Drive, Eugene, OR 97401 | 2016-10-28 |
| 1043760838 | Pacific Crest Trail Detox LLC | Substance Abuse Rehabilitation Facility | 7708 Se Clackamas Rd, Milwaukie, OR 97267-4405 | 2016-10-05 |
| 1477002228 | Treehouse Nw Inc | Substance Abuse Rehabilitation Facility | 4713 N Albina Ave, Suite 301, Portland, OR 97217-2605 | 2016-09-21 |
| 1154785475 | Blvd Centers, Inc | Substance Abuse Rehabilitation Facility | 1316 Se 12th Ave, Portland, OR 97214-3604 | 2016-04-12 |
| 1851757454 | Circle of Trust Healing Center, LLC | Substance Abuse Rehabilitation Facility | 3300 Butler Creek Rd, Ashland, OR 97520-9173 | 2016-01-12 |
| 1700258258 | La Pine Ktc, LLC | Substance Abuse Rehabilitation Facility | 16161 Burgess Rd, La Pine, OR 97739-9533 | 2015-10-23 |
| 1669849212 | Ava Center Inc. | Substance Abuse Rehabilitation Facility | 75 Nw Ava Ave, Gresham, OR 97030-7019 | 2015-08-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.