Organization
GREAT LIFE RANCH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM RYAN WALKER (OPERATIONS OFFICER)
(305) 502-2781
Entity
Organization
Contact information
Practice address
965 FRAZIER HOLLOW RD, DOWELLTOWN, TN 37059-1859
(615) 500-3591
Mailing address
965 FRAZIER HOLLOW RD, DOWELLTOWN, TN 37059-1859
(615) 500-3591
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/28/2016
Last updated
04/28/2016
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