Provider Demographics
NPI:1114403128
Name:TOP OF THE WORLD RANCH MILAN-LLC
Entity Type:Organization
Organization Name:TOP OF THE WORLD RANCH MILAN-LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SADLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-814-8885
Mailing Address - Street 1:3333 155TH AVE
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:IL
Mailing Address - Zip Code:61264-7607
Mailing Address - Country:US
Mailing Address - Phone:309-623-4510
Mailing Address - Fax:
Practice Address - Street 1:3333 155TH AVE
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:IL
Practice Address - Zip Code:61264-7607
Practice Address - Country:US
Practice Address - Phone:309-623-4510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-12
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Single Specialty