NPIMap

Organization Active NPI

Sundown M Ranch

  • Substance Abuse Rehabilitation Facility
  • Yakima, WA
National Provider Identifier
1154474104
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
RTF-1064 Issued in WA
Legal business name
SUNDOWN M RANCH
Practice address
2280 State Route 821
Yakima, WA 98901-8302
Phone
(509) 457-0990
NPI assigned
Jan 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Authorized official

Name
Mark Loes, SUPD, MBANPI 1679009732
Title
Director of Operations
Phone
(509) 969-0092

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X RTF-1064 WA
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X RTF-1064 WA
Substance Abuse Rehabilitation Facility 324500000X RTF-1064 WA Primary
Children's Substance Abuse Rehabilitation Facility 3245S0500X RTF-1064 WA

Addresses

Primary practice location

2280 State Route 821
Yakima, WA 98901-8302

Mailing address

PO Box 217
Selah, WA 98942-0217
Phone (509) 457-0990

Other identifiers 1

IdentifierTypeStateIssuer
1003772MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Sundown M Ranch2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 65

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1154474104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 217",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "989420217",
            "telephone_number": "509-457-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 STATE ROUTE 821",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989018302",
            "telephone_number": "509-457-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDOWN M RANCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-20",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "LOES",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "509-969-0092",
        "authorized_official_credential": "SUPD, MBA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "WA",
            "license": "RTF-1064",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "WA",
            "license": "RTF-1064",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "WA",
            "license": "RTF-1064",
            "primary": true
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "WA",
            "license": "RTF-1064",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003772",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.