Renaissance Ranch Outpatient, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

16330 Issued in NV

Legal business name

RENAISSANCE RANCH OUTPATIENT, LLC

Practice address

3037 E Warm Springs Rd
Suite 400
Las Vegas, NV 89120-3758

Phone

(435) 680-1459

NPI assigned

Sep 1, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Michae Keenan

Title

Owner

Phone

(435) 680-1459

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485907200000",
    "number": "1376090910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 1470 S",
            "address_2": "SUITE 100",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847706798",
            "telephone_number": "702-983-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3037 E WARM SPRINGS RD",
            "address_2": "SUITE 400",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203758",
            "telephone_number": "435-680-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE RANCH OUTPATIENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2017-02-01",
        "status": "A",
        "authorized_official_last_name": "KEENAN",
        "authorized_official_first_name": "MICHAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-680-1459",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NV",
            "license": "16330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Adult Mental Health Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.