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Organization

RENAISSANCE RANCH OUTPATIENT TREATMENT

Active
Parent organization
RENAISSANCE RANCH OUTPATIENT TREATMENT
Other names
Renaissance Ranch Outpatient - Farmington
Organization subpart
Yes

Provider details

NPI number
Legal business name
RENAISSANCE RANCH OUTPATIENT TREATMENT
Authorized official
CHERYL WACK (BILLING MANAGER)
(801) 381-2928
Entity
Organization

Contact information

Practice address
1466 N HIGHWAY 89 STE 230, FARMINGTON, UT 84025-2738
(801) 572-4325
Mailing address
1466 N HIGHWAY 89 STE 230, FARMINGTON, UT 84025-2738

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
4625
UT

Other

Enumeration date
01/25/2016
Last updated
01/25/2016
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