American Eagle Boys Ranch, LLC
Organization Active NPI Emotionally Disturbed Childrens' Residential Treatment Facility · Somerton, AZ
NPI 1669644167 · NPPES record last updated Mar 25, 2008
Key facts
- NPI
- 1669644167
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X
- License
- BH-2805 (AZ)
- Legal business name
- AMERICAN EAGLE BOYS RANCH, LLC
- Practice address
- 3536 W Venus Dr
Somerton, AZ 85350-7245 - Phone
- (928) 726-6764
- NPI assigned
- Mar 25, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Neil Hansen
- Title
- Owner/Administrator
- Phone
- (928) 726-6764
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | BH-2805 | AZ | Yes |
Addresses
Primary practice location
3536 W Venus Dr
Somerton, AZ 85350-7245
Mailing address
PO Box 508
Yuma, AZ 85366-0508
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 921850 | Medicaid | AZ |
Other providers in Somerton, AZ
- Ignacio Aguilar III
- Daniel Amaya
- American Eagle Behavioral Health Agency
- Norma Arreola
- Jody Marie Attaway
- Stephen Douglas Bailey
- Miriam G Beltran
- Mark Beverly
All providers in Somerton, AZ · Emotionally Disturbed Childrens' Residential Treatment Facility in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.