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General NPI Number Information
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NPI Number | 1053782805
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Entity Type | Organization
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Legal Business Name | HASINAI RANCH, LLC
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Dates
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Enumeration Date | 10/19/2015
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Last Update Date | 10/19/2015
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Provider Practice Location Address
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Address Line | 701 OAK FOREST DR
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City | DRIPPING SPRINGS
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State | TX
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Zip | 78620-3227
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Country | US
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Telephone | 888-820-7590
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1099
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City | DRIPPING SPRINGS
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State | TX
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Zip | 78620-1099
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Country | US
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Telephone | 888-820-7590
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JOEL EDWARDS
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Credential |
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Telephone | 949-675-0006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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