NPIMap

Organization Active NPI

Renaissance Ranch Pornography Addiction Treatment Program

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sandy, UT
National Provider Identifier
1780129445
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
37087 Issued in UT
Legal business name
RENAISSANCE RANCH PORNOGRAPHY ADDICTION TREATMENT PROGRAM
Practice address
9160 S 300 W
Sandy, UT 84070-2655
Phone
(801) 856-7836
NPI assigned
Jan 4, 2017
Organization subpart
Yes
Parent organization
AWAKENING BEHAVIORAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Authorized official

Name
Wendy Patton, LSUDC
Title
Administative Director
Phone
(801) 856-7836

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 37087 UT Primary

Addresses

Primary practice location

9160 S 300 W
Sandy, UT 84070-2655

Mailing address

2973 West 138000 South
Bluffdale, UT 84065

National Provider Directory

National Provider Directory
Part of
Awakening Behavioral Health LLC

Locations

9160 S 300 W
Sandy, UT 84070
Phone (801) 856-7836

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1780129445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2973 WEST 138000 SOUTH",
            "city": "BLUFFDALE",
            "state": "UT",
            "postal_code": "84065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9160 S 300 W",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840702655",
            "telephone_number": "801-856-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE RANCH PORNOGRAPHY ADDICTION TREATMENT PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AWAKENING BEHAVIORAL HEALTH",
        "enumeration_date": "2017-01-04",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "ADMINISTATIVE  DIRECTOR",
        "authorized_official_telephone_number": "801-856-7836",
        "authorized_official_credential": "LSUDC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "UT",
            "license": "37087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.