Historic Pines Youth Ranch LLC
NPI #1023322492 in Westcliffe, Colorado
Provider Information
- NPI Number
- 1023322492
- Entity Type
- Organization
- Organization Name
- Historic Pines Youth Ranch LLC
- Primary Specialty
- Psychiatric Residential Treatment Facility
- Enumeration Date
- Jul 28, 2010
- Last Updated
- Jul 28, 2010
Practice Location
- Address
- 379 CHALICE DRIVE
- City
- Westcliffe
- State
- Colorado
- ZIP Code
- 81252
- Phone
- (801) 735-5971
Authorized Official
- Name
- CHRISTY PECK KANE, HMC
- Title
- DIRECTOR
- Phone
- (702) 430-6206
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
| Psychiatric Residential Treatment Facility |
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