RENAISSANCE CDA RE LLC NPI 1871461335

NPI Information

  • NPI: 1871461335
  • Provider Name: RENAISSANCE CDA RE LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Address: 4334 N BRIGHT ANGEL AVE
    MERIDIAN, ID
    ZIP 83646
  • Phone: (208) 376-7298

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NPI Details

RENAISSANCE CDA RE LLC is an assisted living facility in Meridian, ID. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. RENAISSANCE CDA RE LLC NPI is 1871461335. The provider is registered as an organization entity type.

The provider's business location address is:

4334 N BRIGHT ANGEL AVE
MERIDIAN, ID
ZIP 83646-611
Phone: (208) 376-7298
Fax: (208) 377-8310

The provider's authorized official is Kameron Lemon .
The authorized official title is Member and has the following contact phone number (208) 376-7298.

The enumeration date for this NPI number is 10/27/2025 and was last updated on 10/27/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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