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General NPI Number Information
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NPI Number | 1073871398
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Entity Type | Organization
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Legal Business Name | RANCH ACADEMY AND LIFE SKILLS CENTER, INC.
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 04/24/2012
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Provider Practice Location Address
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Address Line | 1311 W IRVING BLVD
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City | IRVING
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State | TX
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Zip | 75061-7220
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Country | US
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Telephone | 972-259-1678
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Fax | 972-259-1684
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Provider Business Mailing Address
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Address Line | 3120 VZCR 2318
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City | CANTON
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State | TX
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Zip | 75103
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Country | US
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Telephone | 903-479-3601
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Fax | 903-479-1161
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Authorized Official
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Title or Position | ASSISTANT CEO
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Name | MR. RICHARD E BOARDMAN
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Credential |
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Telephone | 903-479-3601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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