MCCROSSAN BOYS RANCH NPI 1407988108

NPI Information

NPI: 1407988108
Provider Name: MCCROSSAN BOYS RANCH
Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
47135 260TH ST
SIOUX FALLS, SD
ZIP 57107
Phone: (605) 339-1203
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MCCROSSAN BOYS RANCH is a residential treatment facility emotionally disturbed children in Sioux Falls, SD. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. MCCROSSAN BOYS RANCH NPI is 1407988108. The provider is registered as an organization entity type.

The provider's business location address is:

47135 260TH ST
SIOUX FALLS, SD
ZIP 57107-428
Phone: (605) 339-1203
Fax: (605) 339-3144

The provider's authorized official is Darla K Krueger .
The authorized official title is Business Manager and has the following contact phone number (605) 339-1203.

The enumeration date for this NPI number is 3/9/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children		97333	SOUTH DAKOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5160010	MEDICAID	SOUTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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