Provider Demographics
NPI:1215488325
Name:RANCH FOR KIDS PROJECT, INC.
Entity type:Organization
Organization Name:RANCH FOR KIDS PROJECT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:SUTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-250-0464
Mailing Address - Street 1:PO BOX 116
Mailing Address - Street 2:
Mailing Address - City:REXFORD
Mailing Address - State:MT
Mailing Address - Zip Code:59930-0116
Mailing Address - Country:US
Mailing Address - Phone:406-297-7592
Mailing Address - Fax:406-297-7592
Practice Address - Street 1:144 GATEWAY STREET
Practice Address - Street 2:
Practice Address - City:REXFORD
Practice Address - State:MT
Practice Address - Zip Code:59930
Practice Address - Country:US
Practice Address - Phone:406-297-7592
Practice Address - Fax:406-297-7592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-24
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPAP-PAP-LIC-580320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness