| Fostering Life Youth Ranch, Llc | |
|
1515 5th St Levelland TX 79336-3311 | |
| (575) 703-1919 | |
| Not Available |
| Full Name | Fostering Life Youth Ranch, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1515 5th St, Levelland, Texas |
| Authorized Official Name and Position | Ronald M Foster (PRESIDENT) |
| Authorized Official Contact | 5757031919 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fostering Life Youth Ranch, Llc 5109 82nd St Ste 7-1203 Lubbock TX 79424-3028 Ph: (575) 703-1919 | Fostering Life Youth Ranch, Llc 1515 5th St Levelland TX 79336-3311 Ph: (575) 703-1919 |
| NPI Number | 1386237881 |
|---|---|
| Provider Enumeration Date | 02/16/2021 |
| Last Update Date | 02/16/2021 |
| Certification Date | 02/16/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386237881 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Children's Hope Residential Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1313 W Washington St, Levelland, TX 79336 Phone: 806-897-9735 Fax: 806-568-0299 |