Organization
RENAISSANCE RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HR BROWN LSAC (EXECUTIVE DIRECTOR)
(801) 545-0406
Entity
Organization
Contact information
Practice address
2829 W 13800 S, BLUFFDALE, UT 84065-5902
(801) 545-0406
(801) 545-1092
Mailing address
2829 W 13800 S, BLUFFDALE, UT 84065-5902
(801) 545-0406
(801) 545-1092
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
13741
UT
Other
Enumeration date
05/15/2008
Last updated
05/15/2008
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