Provider Demographics
NPI:1962877407
Name:THE RANCH RECOVERY CENTERS INC
Entity type:Organization
Organization Name:THE RANCH RECOVERY CENTERS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MESA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-329-2924
Mailing Address - Street 1:12890 QUINTA WAY
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-4852
Mailing Address - Country:US
Mailing Address - Phone:760-329-2959
Mailing Address - Fax:760-329-2953
Practice Address - Street 1:12890 QUINTA WAY
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-4852
Practice Address - Country:US
Practice Address - Phone:760-329-2959
Practice Address - Fax:760-329-2953
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE RANCH RECOVERY CENTERS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA330003BN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility