Bob Belloni Ranch, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

43 Issued in OR

Legal business name

BOB BELLONI RANCH, INC.

Practice address

320 Central Ave Ste 406
Coos Bay, OR 97420-2241

Phone

(541) 269-0321

NPI assigned

Oct 15, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Roger Langlie

Title

Executive Director

Phone

(541) 269-0321

Specialties & licenses 1

Addresses

Tax ID family

Bob Belloni Ranch Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Bob Belloni Ranch Inc.

  • Community/Behavioral Health Agency
  • Coos Bay, OR
  • NPI 1376165068
  NPD tax ID
• Bob Belloni Ranch, Inc.

  • Behavior Analyst
  • Coos Bay, OR
  • NPI 1568899243
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385942400000",
    "number": "1093040693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 CENTRAL AVE STE 406",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 CENTRAL AVE STE 406",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202241",
            "telephone_number": "541-269-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOB BELLONI RANCH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-15",
        "last_updated": "2013-12-02",
        "status": "A",
        "authorized_official_last_name": "LANGLIE",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "541-269-0321"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "OR",
            "license": "43",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Michelle Bland
• Celeste Blanken, DO
• Davina Lynn Bledsoe, FNP-BC
• Thomas Blodgett, PHARMD
• Bob Belloni Ranch Inc.
• Bob Belloni Ranch, Inc.
• Anne Marie Bombardier, CRNA
• Kellilynn Bosak, LCSW
• Richard L Bossardt, L.C.S.W.
• Tenzin Bottoroff

• Emotionally Disturbed Childrens' Residential Treatment Facility in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.