The Shepherd's Ranch, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

THE SHEPHERD'S RANCH, INC.

Practice address

209 Hidden Meadows TRL
Mocksville, NC 27028-4976

Phone

(336) 492-2308

Fax

(336) 492-2308

NPI assigned

Jan 8, 2007

Last updated

Aug 22, 2020By 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

Ms. Vicki Lee Robinson, EAP II, CHA II, CSSI

Title

Executive Director

Phone

(336) 492-2308

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hidden Meadows Christian Youth Ranch, Inc. Former legal business name

Tax ID family

Hidden Meadows Christian Youth Ranch Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Shepherds Ranch, Inc.

  • Community/Behavioral Health Agency
  • Lincolnton, NC
  • NPI 1376726083
  NPD tax ID

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972651651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 HIDDEN MEADOWS TRL",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270284976",
            "telephone_number": "336-492-2308",
            "fax_number": "336-492-2308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 HIDDEN MEADOWS TRL",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270284976",
            "telephone_number": "336-492-2308",
            "fax_number": "336-492-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SHEPHERD'S RANCH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-492-2308",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "EAP II, CHA II, CSSI"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300982",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hidden Meadows Christian Youth Ranch, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Karen Sylvester
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• Kelley Taylor, NCLDO
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• Total Restoration Home Health Services, LLC
• Darian Travis
• Triumph LLC

• Community/Behavioral Health Agency in Mocksville, NC
• Providers in Mocksville, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.