# ST. JUDE'S RANCH FOR CHILDREN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043377708
- **Authorized official:** MR. ROLAND CHARLES GANT JR. (RESIDENTIAL COORDINATOR)
- **Authorized official phone:** (702) 294-7101

## Contact information

- **Practice address:** 100 SAINT JUDES ST, BOULDER CITY, NV 89005-1614
- **Practice address phone:** (702) 294-7101
- **Practice address fax:** (702) 294-7191
- **Mailing address:** PO BOX 60100, BOULDER CITY, NV 89006-0100
- **Mailing address phone:** (702) 294-7101
- **Mailing address fax:** (702) 294-7191

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | C3701994 | NV | Yes |

## Other

- **Enumeration date:** 01/02/2007
- **Last updated:** 08/22/2020