RENAISSANCE RANCH OUTPATIENT SANDY WOMEN'S PROGRAM (NPI# 1326583089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326583089 |
| Entity Type | Organization |
| Organization Name | RENAISSANCE RANCH OUTPATIENT SANDY WOMEN'S PROGRAM |
| Practice Address |
9160 S 300 W # 13 Sandy UT 84070-2655 |
| Mailing Address |
2973 West 138000 South Bluffdale UT 84065-2655 |
| Practice Telephone | 8015450406 |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2017-01-26 |
| Authorized Official Name | WENDY PATTON (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Telephone | 8018567836 |
| Authorized Official Credential | LSUDC |
| Is Organization Subpart | Y |
| Parent Organization Name | AWAKENING BEHAVIORAL HEALTH |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
37088 | UT | Ambulatory Health Care Facilities |
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
37087 | UT | Ambulatory Health Care Facilities |
| Street Address |
9160 S 300 W # 13 |
| City | SANDY |
| State | UT |
| Zip Code | 84070-2655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609000561 | Robert E Banta | Social Worker | 9160 S 300 W, Suite 22, Sandy, UT 84070-2655 | 2009-05-06 |
| 1780129445 | Renaissance Ranch Pornography Addiction Treatment Program | Clinic/Center | 9160 S 300 W, Sandy, UT 84070-2655 | 2017-01-04 |
| 1942600846 | Renassaince Ranch Outpatient | Substance Abuse Rehabilitation Facility | 9160 S 300 W, 13, Sandy, UT 84070-2655 | 2014-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639777568 | Megan Komatsu Inc. | Social Worker | 10815 700 East, Sandy, UT 84070 | 2020-10-13 |
| 1841803137 | Anywhere Care | Nurse Practitioner | 9980 S. 300 W. Suite 200, Sandy, UT 84070 | 2020-08-26 |
| 1245840552 | Kirandeep Kaur | Psychologist | 9678 700 E # 102, Sandy, UT 84070 | 2020-08-03 |
| 1740890961 | Elizabeth Lowe Madsen | Counselor | 9678 700 East Suite 102, Sandy, UT 84070 | 2020-08-03 |
| 1417597188 | Hayley Burr | Counselor | 8706 700 E, Suite 205, Sandy, UT 84070 | 2020-01-10 |
| 1821656422 | Karen Ritchie | Counselor | 9192 South 300 West, Sandy, UT 84070 | 2019-05-30 |
| 1679068159 | Derek Livingston | Counselor | 11075 State St #35, Sandy, UT 84070 | 2018-06-27 |
| 1891283735 | Alta Rx LLC. | Pharmacy | 9883 South 500 West, Sandy, UT 84070 | 2018-04-26 |
| 1790273704 | The Addiction Medicine Physicians Group, LLC | Registered Nurse | 9160 S 300 E. Ste 25, Sandy, UT 84070 | 2018-04-25 |
| 1841794765 | Caryn Beazel | Physical Therapist | 9350 150 E, Sandy, UT 84070 | 2018-03-23 |
| Find all providers in zip 84070 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528580180 | Brighton House LLC | Clinic/Center | 2945 E Robidoux Rd, Sandy, UT 84093-1128 | 2017-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255943569 | Skull Valley Health Care | Clinic/Center | 1929 N Aaron Dr, Tooele, UT 84074-8112 | 2020-08-18 |
| 1003427923 | Painted Desert Recovery LLC | Clinic/Center | 1947 S 2800 E, New Harmony, UT 84757-5115 | 2020-08-13 |
| 1437780673 | Beecon Recovery | Clinic/Center | 60 S Main St Ste B0001, Brigham City, UT 84302-6795 | 2020-01-27 |
| 1124666870 | One Voice Recovery | Clinic/Center | 1400 S 1100 E, Salt Lake City, UT 84105-2435 | 2019-12-12 |
| 1992343834 | Avante Recovery Center, LLC | Clinic/Center | 848 E 1475 N, Lehi, UT 84043-3568 | 2019-12-11 |
| 1467912139 | Infinite Arches LLC | Clinic/Center | 136 25th St, Ogden, UT 84401-1302 | 2019-03-20 |
| 1669952958 | Utah Harm Reduction Coalition | Clinic/Center | 91 E 7200 S, Midvale, UT 84047-1531 | 2018-08-16 |
| 1871016840 | Breakaway Recovery Center Murray, LLC | Clinic/Center | 5296 S Commerce Dr Ste 204, Murray, UT 84107-5393 | 2017-07-21 |
| 1316392897 | Nuway Recovery, LLC | Clinic/Center | 4925 S 900 E, Salt Lake City, UT 84117-5784 | 2016-05-03 |
| 1578917787 | Deer Hollow Outpatient Services, LLC | Clinic/Center | 12608 S 125 W Ste E, Draper, UT 84020-8437 | 2016-04-14 |
| 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.