Organization
JUDGE JAMES V RIDDEL BOYS RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK MASTERSON (DIRECTOR OF CORRECTIONS)
(316) 660-9750
Entity
Organization
Contact information
Practice address
25331 W 39TH ST S, GODDARD, KS 67052-9244
(316) 660-1600
(316) 794-2061
Mailing address
700 S HYDRAULIC ST, WICHITA, KS 67211-2704
(316) 660-1670
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
0003181-001
KS
Other
Enumeration date
01/25/2007
Last updated
08/22/2020
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