SUNDOWN M RANCH NPI 1154474104

NPI Information

NPI: 1154474104
Provider Name: SUNDOWN M RANCH
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 50D2201949

Address:
2280 STATE ROUTE 821
YAKIMA, WA
ZIP 98901
Phone: (509) 457-0990
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SUNDOWN M RANCH is a substance abuse rehabilitation facility in Yakima, WA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. SUNDOWN M RANCH NPI is 1154474104. The provider is registered as an organization entity type.

The provider's business location address is:

2280 STATE ROUTE 821
YAKIMA, WA
ZIP 98901-302
Phone: (509) 457-0990

The provider's authorized official is Mark Loes .
The authorized official title is Director Of Operations and has the following contact phone number (509) 969-0092.

The CLIA number assigned to this NPI record is 50D2201949 - other - drug treatment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/20/2007 and was last updated on 8/23/2022.

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	251B00000X	Case Management		RTF-1064	WASHINGTON	No
2	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	RTF-1064	WASHINGTON	No
3	3245S0500X	Substance Abuse Rehabilitation Facility	Substance Abuse Treatment, Children	RTF-1064	WASHINGTON	No
4	324500000X	Substance Abuse Rehabilitation Facility		RTF-1064	WASHINGTON	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	1003772	MEDICAID	WASHINGTON

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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