# MCCROSSAN BOYS RANCH

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1407988108
- **Authorized official:** DARLA K KRUEGER (BUSINESS MANAGER)
- **Authorized official phone:** (605) 339-1203

## Contact information

- **Practice address:** 47135 260TH ST, SIOUX FALLS, SD 57107-6428
- **Practice address phone:** (605) 339-1203
- **Practice address fax:** (605) 339-3144
- **Mailing address:** 47135 260TH ST, SIOUX FALLS, SD 57107-6428
- **Mailing address phone:** (605) 339-1203
- **Mailing address fax:** (605) 339-3144

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 97333 | SD | Yes |

## Other

- **Enumeration date:** 03/09/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5160010 | — | SD |