White Pine Boys Ranch, LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

1389-13 Issued in NV

Legal business name

WHITE PINE BOYS RANCH, LLC

Doing business as

Home on the Range Youth Ranch

Practice address

HC 34 Box 34165
Ely, NV 89301-9206

Phone

(775) 238-5100

Fax

(775) 238-5103

NPI assigned

May 15, 2013

Last updated

May 15, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Lawrence Alan Bradley, M.A., LMFT

Title

Executive Director

Phone

(775) 238-5100

Specialties & licenses 2

Addresses

Other names 1

• Home on the Range Youth Ranch Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Erich Baine

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Ely, NV
  • NPI 1114364783

  Residential Treatment Facility, Emotionally Disturbed Children

  NPD (past)
• Amy Campbell

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Ely, NV
  • NPI 1750728085

  Residential Treatment Facility, Emotionally Disturbed Children

  NPD (past)

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1437595568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 34 BOX 34165",
            "city": "ELY",
            "state": "NV",
            "postal_code": "893019206",
            "telephone_number": "775-238-5100",
            "fax_number": "775-238-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 34 BOX 34165",
            "city": "ELY",
            "state": "NV",
            "postal_code": "893019206",
            "telephone_number": "775-238-5100",
            "fax_number": "775-238-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE PINE BOYS RANCH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-15",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "775-238-5100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A., LMFT"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NV",
            "license": "1389-13",
            "primary": true
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "NV",
            "license": "1389-13",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home on the Range Youth Ranch",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew F Walker, PHARMD
• Rosemarie Wallace
• Jessica Wayman
• Casie Ann Weaver
• Elliana Bibasari Webb, COTA
• White Pine Community Training Center Inc.
• White Pine County (White Pine County Ambulance)
• White Pine County
• Todd Carl Wilkin, D.D.S.
• Cade Hunter Willes, DC

• Emotionally Disturbed Childrens' Residential Treatment Facility in Ely, NV
• Providers in Ely, NV by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.