Provider Demographics
NPI:1861507147
Name:KING'S RANCH AND HANNAH HOMES, INC.
Entity Type:Organization
Organization Name:KING'S RANCH AND HANNAH HOMES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LEW
Authorized Official - Last Name:BURDETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-678-8331
Mailing Address - Street 1:PO BOX 162
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:AL
Mailing Address - Zip Code:35043-0162
Mailing Address - Country:US
Mailing Address - Phone:205-678-8331
Mailing Address - Fax:205-678-7372
Practice Address - Street 1:221 DAYSPRING DRIVE
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:AL
Practice Address - Zip Code:35043
Practice Address - Country:US
Practice Address - Phone:205-678-8331
Practice Address - Fax:205-678-7372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000292 & 013071322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children