Provider Demographics
NPI:1275986036
Name:HOPE REMAINS YOUTH RANCH
Entity Type:Organization
Organization Name:HOPE REMAINS YOUTH RANCH
Other - Org Name:HOPE REMAINS RANCH
Other - Org Type:Other Name
Authorized Official - Title/Position:LICENSED MARRIAGE FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MMFT, LMFT
Authorized Official - Phone:864-249-3532
Mailing Address - Street 1:PO BOX 160782
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-0014
Mailing Address - Country:US
Mailing Address - Phone:864-249-3532
Mailing Address - Fax:
Practice Address - Street 1:1771 JOHN DODD RD
Practice Address - Street 2:
Practice Address - City:WELLFORD
Practice Address - State:SC
Practice Address - Zip Code:29385-9744
Practice Address - Country:US
Practice Address - Phone:864-249-3532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health