AWAKENING BEHAVIORAL HEALTH, LLC (NPI# 1619412046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619412046 |
| Entity Type | Organization |
| Organization Name | AWAKENING BEHAVIORAL HEALTH, LLC |
| Other Organization Name | RENAISSANCE RANCH TREATMENT CENTERS |
| Practice Address |
2973 W 13800 S Bluffdale UT 84065-8202 |
| Practice Telephone | 8015450406 |
| Enumeration Date | 2016-12-20 |
| Last Update Date | 2020-03-30 |
| Authorized Official Name | KERRYLYNN BACA-PELPHREY (CCO, EXEC DIR PAYOR RELATIONS) |
| Authorized Official Telephone | 8016589646 |
| Is Organization Subpart | Y |
| Parent Organization Name | AWAKENING BEHAVIORAL HEALTH, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 26066 | UT | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPI FOR SPECIFIC FACILITY RENAISSANCE RANCH BLUFFDALE MEN'S PROG | 1568909117 | 01 | |
| UT | STATE OF UTAH HUMAN SERVICES | 51983 | 01 |
| Other Name | Type Code |
|---|---|
| Renaissance Ranch Bluffdale Men's Program, LLC | Doing Business As Name - Organization |
| Renaissance Ranch Treatment Centers | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962947101 | Awakening Behavioral Health, LLC | Clinic/Center | 9160 S 300 W Ste 3, Sandy, UT 84070-2656 | 2016-12-26 |
| Street Address |
2973 W 13800 S |
| City | BLUFFDALE |
| State | UT |
| Zip Code | 84065-8202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568909117 | Renaissance Ranch Bluffdale Men's Program | Substance Abuse Rehabilitation Facility | 2973 W 13800 S, Bluffdale, UT 84065-8202 | 2017-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972248 | William Lance Andersen | Pharmacist | 1202 W 12600 W, Riverton, UT 84065 | 2020-11-02 |
| 1275172678 | Dentists of Riverton, LLP | Dentist | 4531 W. Partridgehill Lane, Suite F-110, Riverton, UT 84065 | 2020-01-02 |
| 1194201467 | Patrick Kunkel | Dentist | 12569 2700 W, #100, Riverton, UT 84065 | 2018-07-19 |
| 1790274546 | Harmon City Inc | Pharmacy | 13330 South Kestrel Range Road, Riverton, UT 84065 | 2018-05-08 |
| 1386147767 | Richard Hayes Johnston | Counselor | 3740 S Market Center Dr #1200, Riverton, UT 84065 | 2018-03-13 |
| 1023537156 | Brenda Fuell | Dental Hygienist | 12959 South Picket Fence Lane, Riverton, UT 84065 | 2017-09-09 |
| 1407373426 | Bethany Marie Breck | Counselor | 3740 S Market Center Drive, #1200, Riverton, UT 84065 | 2017-08-30 |
| 1952848509 | Renaissance Ranch Bluffdale Women's Program | Substance Abuse Rehabilitation Facility | 2356 Thunderhead Way, Bluffdale, UT 84065 | 2017-01-20 |
| 1053856229 | Bradford Scott Bentley Jr. | Physical Therapist | 3741 W 12600 S, Ste 100, Riverton, UT 84065 | 2016-12-27 |
| 1194273524 | New Horizon | Preferred Provider Organization | 1420 W 12600 Sputh, Draper, UT 84065 | 2016-09-14 |
| Find all providers in zip 84065 | ||||
| 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 |
|---|---|---|---|---|
| 1073046728 | Copper Sage Recovery Center | Substance Abuse Rehabilitation Facility | 14014 S 2200 W, Bluffdale, UT 84065-5325 | 2017-04-10 |
| 1952848509 | Renaissance Ranch Bluffdale Women's Program | Substance Abuse Rehabilitation Facility | 2356 Thunderhead Way, Bluffdale, UT 84065 | 2017-01-20 |
| 1609242593 | Inspire Addiction Recovery LLC | Substance Abuse Rehabilitation Facility | 2356 W Thunderhead Way, Bluffdale, UT 84065-3011 | 2015-08-14 |
| 1710154992 | Renaissance Ranch | Substance Abuse Rehabilitation Facility | 2829 W 13800 S, Bluffdale, UT 84065-5902 | 2008-05-15 |
| 1568909117 | Renaissance Ranch Bluffdale Men's Program | Substance Abuse Rehabilitation Facility | 2973 W 13800 S, Bluffdale, UT 84065-8202 | 2017-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013886 | Brc Wellness LLC | Substance Abuse Rehabilitation Facility | 4911 S 900 E Ste B, Salt Lake City, UT 84117-5747 | 2020-11-06 |
| 1891307104 | Steps Recovery Center | Substance Abuse Rehabilitation Facility | 345 E 4500 S # 100-140, Murray, UT 84107-3991 | 2020-08-18 |
| 1104460666 | Active Recovery, LLC | Substance Abuse Rehabilitation Facility | 25 S Main St # 212, Centerville, UT 84014-1840 | 2019-10-28 |
| 1437709441 | Insight Recovery Cedar City, LLC | Substance Abuse Rehabilitation Facility | 1050 W Old Highway 91, Parowan, UT 84761-7725 | 2019-09-12 |
| 1316506470 | Evnsq, LLC | Substance Abuse Rehabilitation Facility | 5162 S Highland Dr, Holladay, UT 84117-7048 | 2019-06-11 |
| 1114584356 | Juniper Canyon Recovery Center for Women, LLC | Substance Abuse Rehabilitation Facility | 520 North Aspen Road, Loa, UT 84747-8474 | 2019-05-23 |
| 1750948030 | Liberty Addiction Recovery Centers LLC | Substance Abuse Rehabilitation Facility | 10458 N 6570 W, Highland, UT 84003-9311 | 2019-05-22 |
| 1235793290 | Mountain Valley Recovery LLC | Substance Abuse Rehabilitation Facility | 9431 N 400 W, Holden, UT 84636 | 2019-04-25 |
| 1346803525 | Brookstone Foundation | Substance Abuse Rehabilitation Facility | 198 N 100 E # 198n100e, St George, UT 84770-2831 | 2019-04-15 |
| 1639649684 | Sterling Recovery | Substance Abuse Rehabilitation Facility | 525 W 465 N Ste 130, Providence, UT 84332-5604 | 2018-12-03 |
| 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.