Provider Demographics
NPI:1376726083
Name:THE SHEPHERDS RANCH, INC.
Entity Type:Organization
Organization Name:THE SHEPHERDS RANCH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHULTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-748-9533
Mailing Address - Street 1:P.O. BOX 901
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28093-0901
Mailing Address - Country:US
Mailing Address - Phone:704-748-9533
Mailing Address - Fax:704-748-9531
Practice Address - Street 1:113 S OAK ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3400
Practice Address - Country:US
Practice Address - Phone:704-748-9533
Practice Address - Fax:704-748-9531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health