Organization
RENAISSANCE RANCH OUTPATIENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAE KEENAN (OWNER)
(435) 680-1459
Entity
Organization
Contact information
Practice address
3037 E WARM SPRINGS RD, SUITE 400, LAS VEGAS, NV 89120-3758
(435) 680-1459
Mailing address
120 W 1470 S, SUITE 100, ST GEORGE, UT 84770-6798
(702) 983-4464
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
16330
NV
Other
Enumeration date
09/01/2016
Last updated
02/01/2017
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