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Organization
BETHANY RANCH HOME, INC
Active
Organization
BETHANY RANCH HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARBARA OXLEY N.M.D., RN, BSN, MSN (EXECUTIVE DIRECTOR)
(602) 616-3470
Entity
Organization
Contact information
Practice address
6130 N 16TH ST, PHOENIX, AZ 85016-1705
(602) 616-3470
Mailing address
6130 N 16TH ST, PHOENIX, AZ 85016-1705
(602) 616-3470
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
AZ
261QD1600X
Developmental Disabilities Clinic/Center
—
AZ
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
AZ
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
AZ
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
AZ
347C00000X
Private Vehicle
—
AZ
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E2104999
ARIZONA PROVIDER ID
AZ
Enumeration date
04/04/2007
Last updated
09/11/2025
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