Provider Demographics
NPI:1508321472
Name:RANCH HOPE INC
Entity Type:Organization
Organization Name:RANCH HOPE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:856-935-1555
Mailing Address - Street 1:PO BOX 325
Mailing Address - Street 2:
Mailing Address - City:ALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08001-0325
Mailing Address - Country:US
Mailing Address - Phone:856-935-1555
Mailing Address - Fax:
Practice Address - Street 1:45 SAWMILL ROAD
Practice Address - Street 2:
Practice Address - City:ALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08001-0325
Practice Address - Country:US
Practice Address - Phone:856-935-1555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RANCH HOPE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-05
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8371709Medicaid