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General NPI Number Information
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NPI Number | 1225173263
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Entity Type | Organization
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Legal Business Name | SUNDOWN RANCH, INC.
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 01/13/2015
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Provider Practice Location 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 | 903-479-3933
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Fax | 903-479-3222
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Provider Business Mailing 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 | 903-479-3933
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Fax | 903-479-3222
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MR. STEVEN WAYNE ECHOLS
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Credential |
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Telephone | 903-479-3933
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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 | 369A
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License Number State | TX
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