Organization
FLORIDA SHERIFFS YOUTH RANCHES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER O BOUCHARD JR. (PRESIDENT)
(386) 842-5501
Entity
Organization
Contact information
Practice address
751 RYE WILDERNESS RD NE, BRADENTON, FL 34212-9461
(941) 776-1777
(941) 776-2812
Mailing address
PO BOX 2000, LIVE OAK, FL 32064-1550
(386) 842-5501
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/23/2006
Last updated
08/22/2020
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