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General NPI Number Information
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NPI Number | 1952000358
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Entity Type | Organization
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Legal Business Name | BUDDYS RANCH LLC
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Dates
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Enumeration Date | 02/24/2023
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Last Update Date | 03/20/2024
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Provider Practice Location Address
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Address Line | 6070 ALBERTA AVE
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City | MARYSVILLE
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State | CA
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Zip | 95901-8031
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Country | US
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Telephone | 530-434-4595
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 802
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City | YUBA CITY
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State | CA
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Zip | 95992-0802
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Country | US
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Telephone | 530-632-8219
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Fax | 916-500-0609
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Authorized Official
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Title or Position | CFO
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Name | THOMAS HARRIS
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Credential |
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Telephone | 530-632-8219
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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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