Active NPI
Renewed Horizons, LLC
- Developmentally Disabled Services Day Training Agency
- Hayden, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmentally Disabled Services Day Training Agency
- License
- DDA-999
- Legal business name
- RENEWED HORIZONS, LLC
- Practice address
- 8252 N Wayne Dr
Hayden, ID 83835-5029 - Phone
- (208) 704-8008
- NPI assigned
- Nov 18, 2014
- Last updated
- Dec 12, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Scott Gordon Hansen
- Title
- Administrator
- Phone
- (208) 704-8008
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | DDA-999 | ID | Primary |
Addresses
Primary practice location
8252 N Wayne Dr
Hayden, ID 83835-5029
Mailing address
8252 N Wayne Dr
Hayden, ID 83835-5029
Phone (208) 704-8008
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DDA-999 | Medicaid | ID |
National Provider Directory
National Provider Directory- Tax ID family
- Renewed Horizons LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Hayden, ID
- NPI 1235907973
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Hayden, ID
- NPI 1346791944
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Developmental Therapist
- Hayden, ID
- NPI 1871999888
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416268800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1702339200000",
"number": "1396141305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8252 N WAYNE DR",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838355029",
"telephone_number": "208-704-8008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8252 N WAYNE DR",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838355029",
"telephone_number": "208-704-8008"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RENEWED HORIZONS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-11-18",
"last_updated": "2023-12-12",
"certification_date": "2023-12-12",
"status": "A",
"authorized_official_last_name": "HANSEN",
"authorized_official_first_name": "SCOTT",
"authorized_official_middle_name": "GORDON",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "208-704-8008"
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": "ID",
"license": "DDA-999",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DDA-999",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hayden, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.