Rocky Creek Youth Ranch Incorportated

Organization Active NPI Emotionally Disturbed Childrens' Residential Treatment Facility · Park Hills, MO

NPI 1790148971 · NPPES record last updated Apr 4, 2016

Key facts

NPI
1790148971
Entity type
Organization (NPI type 2)
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X
License
N000701465 (MO)
Legal business name
ROCKY CREEK YOUTH RANCH INCORPORTATED
Practice address
1286 Matthews LN
Park Hills, MO 63601-7207
Phone
(573) 562-7751
NPI assigned
Apr 4, 2016
Organization subpart
No

Authorized official

Name
Cliff Talley
Title
Executive Director
Phone
(573) 562-7751

Practitioners 5

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

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X N000701465 MO Yes

Addresses

Primary practice location

1286 Matthews LN
Park Hills, MO 63601-7207

Mailing address

1286 Matthews LN
Park Hills, MO 63601-7207

Other providers in Park Hills, MO

All providers in Park Hills, MO · Emotionally Disturbed Childrens' Residential Treatment Facility in Missouri

Sources for this page

Verify at the official NPI Registry.