WHITE PINE BOYS RANCH, LLC (NPI# 1437595568) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437595568 |
| Entity Type | Organization |
| Organization Name | WHITE PINE BOYS RANCH, LLC |
| Other Organization Name | HOME ON THE RANGE YOUTH RANCH |
| Practice Address |
Hc 34 Box 34165 Ely NV 89301-9206 |
| Practice Telephone | 7752385100 |
| Practice Fax Number | 7752385103 |
| Mailing Telephone | 7752385100 |
| Mailing Fax Number | 7752385103 |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2013-05-15 |
| Authorized Official Name | MR. LAWRENCE ALAN BRADLEY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7752385100 |
| Authorized Official Credential | M.A., LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
1389-13 | NV | Residential Treatment Facilities |
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 1389-13 | NV | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Home on the Range Youth Ranch | Doing Business As Name - Organization |
| Street Address |
HC 34 BOX 34165 |
| City | ELY |
| State | NV |
| Zip Code | 89301-9206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750728085 | Amy Campbell | Residential Treatment Facility, Emotionally Disturbed Children | Hc 34 Box 34165, Ely, NV 89301-9206 | 2013-05-28 |
| 1114364783 | James Erich Baine | Residential Treatment Facility, Emotionally Disturbed Children | Hc 34 Box 34165, Ely, NV 89301-9206 | 2013-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144650722 | Srs-ely LLC | Clinic/Center | 701 East 15th Street, Ely, NV 89301 | 2013-11-19 |
| 1538419650 | Sanderling Renal Services-usa, LLC | Clinic/Center | 701 East 15th St, Ely, NV 89301 | 2012-09-17 |
| 1003942707 | Kent M Robertson Od Inc | Optometrist | 409 Murry St, Ely, NV 89301 | 2007-02-26 |
| 1356442651 | Jeffrey B Willes | Chiropractor | 664 14th Street East, Ely, NV 89301 | 2006-09-26 |
| 1295773752 | Aerocare, Inc. | Durable Medical Equipment & Medical Supplies | 802 Avenue E Ste 124&6, Ely, NV 89301 | 2006-06-04 |
| 1548217409 | Ely Shoshone Tribe | Clinic/Center | 400 Newe View, Ely, NV 89301 | 2006-05-27 |
| 1437145422 | William Bee Ririe Hospital | Emergency Medicine | 6 Steptoe Circle, Ely, NV 89301 | 2005-09-23 |
| 1538669635 | Kenyatta D Weathersby | Community/Behavioral Health | 3925 N. Martin Luther King Blvd, Ste 211, N. Las Vegas, NV 89301 | 2018-02-15 |
| 1225430861 | Amy Sue Barney | Nurse Practitioner | 6 Steptoe Circle, Ely, NV 89301 | 2014-09-25 |
| 1114238540 | David Byun | Internal Medicine | 1500 Avenue H, Ely, NV 89301 | 2010-06-30 |
| Find all providers in zip 89301 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750728085 | Amy Campbell | Residential Treatment Facility, Emotionally Disturbed Children | Hc 34 Box 34165, Ely, NV 89301-9206 | 2013-05-28 |
| 1114364783 | James Erich Baine | Residential Treatment Facility, Emotionally Disturbed Children | Hc 34 Box 34165, Ely, NV 89301-9206 | 2013-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891282786 | Avenues 2 Success | Residential Treatment Facility, Emotionally Disturbed Children | 9520 Chanticleer Ct, Las Vegas, NV 89129-7858 | 2018-04-17 |
| 1215305818 | Levada House LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3905 Clear Acre Ln Apt 27, Reno, NV 89512-1283 | 2015-09-13 |
| 1639423064 | Sunny Day Home Health | Residential Treatment Facility, Emotionally Disturbed Children | 1712 Sagebrush Ranch Way, N Las Vegas, NV 89081-6718 | 2012-11-07 |
| 1093030017 | Unepected Changes | Residential Treatment Facility, Emotionally Disturbed Children | 428 Marion Dr, Las Vegas, NV 89110-3473 | 2010-04-01 |
| 1245567486 | Luvin' Kare Transitional Services | Residential Treatment Facility, Emotionally Disturbed Children | 217 Delighted Ave, North Las Vegas, NV 89031-1395 | 2009-11-09 |
| 1679703805 | Horizon Academy LLC | Residential Treatment Facility, Emotionally Disturbed Children | Hc 70 Box 531, Amargosa Valley, NV 89020-9600 | 2009-07-22 |
| 1174766612 | Carol Ellen Harrison | Residential Treatment Facility, Emotionally Disturbed Children | 1700 Buckthorn Ct, Minden, NV 89423-4127 | 2009-04-14 |
| 1700046372 | London Family and Children's Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2026 Silverton Dr, Henderson, NV 89074-1550 | 2008-06-16 |
| 1588821938 | Focal Point Academy | Residential Treatment Facility, Emotionally Disturbed Children | 560 W Mesquite Blvd, Mesquite, NV 89027-5137 | 2008-05-21 |
| 1306024773 | Father Flanagans Boys' Town | Residential Treatment Facility, Emotionally Disturbed Children | 8090 Flanagan Dr, Las Vegas, NV 89131-0200 | 2008-02-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.