NPI 1114692373

Renaissance Ranch Heyburn

Organisation Substance Abuse Rehabilitation Facility Heyburn, ID

Practice location

Address: 312 S 950 W, Heyburn, ID 83336-9765
Phone: (855) 736-7262

Authorised official

Name: Tyson Blaine Dixon
Title: Owner
Phone: (801) 860-0118

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X

Other Substance Abuse Rehabilitation Facility providers in Idaho →

Registry record

NPI: 1114692373
Entity type: Organization
NPI issued: 10 Aug 2021
Record last updated: 10 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.