Provider Demographics
NPI:1386197861
Name:RANLIEGH MCCLELLAND
Entity Type:Organization
Organization Name:RANLIEGH MCCLELLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL HEALTH SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:RANLIEGH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLELLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-589-5242
Mailing Address - Street 1:1433 Q RD
Mailing Address - Street 2:
Mailing Address - City:LOMA
Mailing Address - State:CO
Mailing Address - Zip Code:81524-9430
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1433 Q RD
Practice Address - Street 2:
Practice Address - City:LOMA
Practice Address - State:CO
Practice Address - Zip Code:81524-9430
Practice Address - Country:US
Practice Address - Phone:970-589-5242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health