Provider Demographics
NPI:1073629226
Name:THE RANCH AT DOVE TREE, LLC
Entity Type:Organization
Organization Name:THE RANCH AT DOVE TREE, LLC
Other - Org Name:DOVE TREE RANCH
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF LEGAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-716-4924
Mailing Address - Street 1:2559 SW GRAPEVINE PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-1000
Mailing Address - Country:US
Mailing Address - Phone:817-287-0060
Mailing Address - Fax:817-287-0070
Practice Address - Street 1:1406 E COUNTY ROAD 5800
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79403-6700
Practice Address - Country:US
Practice Address - Phone:806-746-6777
Practice Address - Fax:807-746-6770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2236-A324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility