Provider Demographics
NPI:1487454492
Name:RENAISSANCE SENIOR CARE, LLC
Entity type:Organization
Organization Name:RENAISSANCE SENIOR CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HUMAN RESOURCES
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-227-1577
Mailing Address - Street 1:PO BOX 1687
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83403-1687
Mailing Address - Country:US
Mailing Address - Phone:208-227-1577
Mailing Address - Fax:208-227-1578
Practice Address - Street 1:1025 E CENTER ST
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725-3215
Practice Address - Country:US
Practice Address - Phone:406-683-4002
Practice Address - Fax:406-683-6656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility