NPIMap

Organization Active NPI

Renassaince Ranch Outpatient

  • Substance Abuse Rehabilitation Facility
  • Sandy, UT
National Provider Identifier
1942600846
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
4625 Issued in UT
Legal business name
RENASSAINCE RANCH OUTPATIENT
Practice address
9160 S 300 W
13
Sandy, UT 84070-2655
Phone
(801) 450-7893
NPI assigned
Aug 27, 2014
Last updated
Sep 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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

Authorized official

Name
Dr. Cory Allen Reich, PH.D., L.M.F.T.
Title
Clinical Director
Phone
(801) 450-7893

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 4625 UT Primary

Addresses

Primary practice location

9160 S 300 W
13
Sandy, UT 84070-2655

Mailing address

9160 S 300 W
13
Sandy, UT 84070-2655
Phone (801) 450-7893

National Provider Directory

National Provider Directory
Tax ID family
Renassaince Ranch Outpatient4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410393600000",
    "number": "1942600846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9160 S 300 W",
            "address_2": "13",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840702655",
            "telephone_number": "801-450-7893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9160 S 300 W",
            "address_2": "13",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840702655",
            "telephone_number": "801-450-7893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENASSAINCE RANCH OUTPATIENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "last_updated": "2014-09-11",
        "status": "A",
        "authorized_official_last_name": "REICH",
        "authorized_official_first_name": "CORY",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "801-450-7893",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., L.M.F.T."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "UT",
            "license": "4625",
            "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 Sep 11, 2014; 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.