Provider Demographics
NPI:1316174261
Name:THE RANCH
Entity type:Organization
Organization Name:THE RANCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAPLESDEN
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, CHC, CHPC
Authorized Official - Phone:615-510-3078
Mailing Address - Street 1:PO BOX 670532
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-0532
Mailing Address - Country:US
Mailing Address - Phone:615-567-7282
Mailing Address - Fax:615-807-2931
Practice Address - Street 1:6107 PINEWOOD RD
Practice Address - Street 2:
Practice Address - City:NUNNELLY
Practice Address - State:TN
Practice Address - Zip Code:37137-2523
Practice Address - Country:US
Practice Address - Phone:954-587-7771
Practice Address - Fax:954-252-2177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000017855323P00000X
TNL000000003995324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility