Organization
RENEWED FOUNDATIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAWN LAPRAY (CEO)
(208) 360-1886
Entity
Organization
Contact information
Practice address
725 S WOODRUFF AVE STE 401, IDAHO FALLS, ID 83401-5286
(208) 360-1886
Mailing address
382 FIRE THORN, IDAHO FALLS, ID 83404-4954
(208) 360-1886
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/09/2024
Last updated
11/04/2024
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