NPIMap

Organization Active NPI

St. Jude's Ranch for Children

  • Community/Behavioral Health Agency
  • Boulder City, NV
National Provider Identifier
1790089209
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ST. JUDE'S RANCH FOR CHILDREN
Practice address
100 Saint Judes St
Boulder City, NV 89005-1614
Phone
(702) 294-7100
Fax
(702) 294-7171
NPI assigned
Dec 28, 2010
Last updated
Aug 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

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

Authorized official

Name
Mrs. Hannah L Ware, LMFTNPI 1104128347
Title
Clinical Director
Phone
(702) 294-7135

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

100 Saint Judes St
Boulder City, NV 89005-1614

Mailing address

PO Box 60100
Boulder City, NV 89006-0100
Phone (702) 294-7100

Other identifiers 2

IdentifierTypeStateIssuer
9005043441MedicaidNV
9005043433MedicaidNV

National Provider Directory

National Provider Directory
Tax ID family
St Jude's Ranch for Children3 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.

Practitioners & affiliated clinicians

Practitioners 74

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.

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406851200000",
    "number": "1790089209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60100",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890060100",
            "telephone_number": "702-294-7100",
            "fax_number": "702-294-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SAINT JUDES ST",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890051614",
            "telephone_number": "702-294-7100",
            "fax_number": "702-294-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JUDE'S RANCH FOR CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-28",
        "last_updated": "2014-08-01",
        "status": "A",
        "authorized_official_last_name": "WARE",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "702-294-7135",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9005043441",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9005043433",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder City, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; 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.