Provider Demographics
NPI:1073871398
Name:RANCH ACADEMY AND LIFE SKILLS CENTER, INC.
Entity Type:Organization
Organization Name:RANCH ACADEMY AND LIFE SKILLS CENTER, INC.
Other - Org Name:THE RANCH ACADEMY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOARDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-479-3601
Mailing Address - Street 1:3120 VZCR 2318
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:TX
Mailing Address - Zip Code:75103
Mailing Address - Country:US
Mailing Address - Phone:903-479-3601
Mailing Address - Fax:903-479-1161
Practice Address - Street 1:1311 W IRVING BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-7220
Practice Address - Country:US
Practice Address - Phone:972-259-1678
Practice Address - Fax:972-259-1684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)