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General NPI Number Information
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NPI Number | 1487454492
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Entity Type | Organization
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Legal Business Name | RENAISSANCE SENIOR CARE, LLC
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 1025 E CENTER ST
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City | DILLON
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State | MT
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Zip | 59725-3215
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Country | US
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Telephone | 406-683-4002
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Fax | 406-683-6656
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Provider Business Mailing Address
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Address Line | PO BOX 1687
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City | IDAHO FALLS
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State | ID
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Zip | 83403-1687
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Country | US
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Telephone | 208-227-1577
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Fax | 208-227-1578
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Authorized Official
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Title or Position | DIRECTOR OF HUMAN RESOURCES
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Name | LINDA BECK
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Credential |
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Telephone | 208-227-1577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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