Roots Adolescent Renewal Ranch

Primary specialty

Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X

Legal business name

ROOTS ADOLESCENT RENEWAL RANCH

Practice address

819 Indian TRL
Argyle, TX 76226-6831

Phone

(888) 399-0489

NPI assigned

Oct 27, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Heather Hudiburgh

Title

Director of Operations

Phone

(940) 999-8529

Specialties & licenses 1

Addresses

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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

• Nicole Hoffman, LPC, LCDC

  • Professional Counselor
  • Flower Mound, TX
  • NPI 1578152542
  NPD (past)

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1700540515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 INDIAN TRL",
            "city": "ARGYLE",
            "state": "TX",
            "postal_code": "762266831",
            "telephone_number": "888-399-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 INDIAN TRL",
            "city": "ARGYLE",
            "state": "TX",
            "postal_code": "762266831",
            "telephone_number": "888-399-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS ADOLESCENT RENEWAL RANCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-27",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "HUDIBURGH",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "940-999-8529",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.lightningstep.com",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "819 Indian Trl",
            "city": "Argyle",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762266831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kirk A Rexroat, B.S., D.C.
• Kendal Rice, MA, LPC-ASSOCIATE
• Alecia Marie Rickenbach, FNP
• Richard Ritcherson
• Timothy Boyd Roberson, PA-C
• Elizabeth Avery Rowles, LCP
• Faith Marie Russell, RN
• Mark Andrew Sams, LCSW, LCDC
• Krysta Dawn Sanchez
• Sante Center Outpatient Services

• Children's Substance Abuse Rehabilitation Facility in Argyle, TX
• Providers in Argyle, TX by specialty
• Children's Substance Abuse Rehabilitation Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.