Organization
ST. JUDE'S RANCH FOR CHILDREN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HANNAH L WARE LMFT (CLINICAL DIRECTOR)
(702) 294-7135
Entity
Organization
Contact information
Practice address
100 SAINT JUDES ST, BOULDER CITY, NV 89005-1614
(702) 294-7100
(702) 294-7171
Mailing address
PO BOX 60100, BOULDER CITY, NV 89006-0100
(702) 294-7100
(702) 294-7171
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9005043433
—
NV
05
—
9005043441
—
NV
Enumeration date
12/28/2010
Last updated
08/01/2014
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