Provider Demographics
NPI:1881707909
Name:ALABAMA SHERIFFS' YOUTH RANCHES, INC.
Entity type:Organization
Organization Name:ALABAMA SHERIFFS' YOUTH RANCHES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:RAUCCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-213-2071
Mailing Address - Street 1:PO BOX 240009
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36124-0009
Mailing Address - Country:US
Mailing Address - Phone:334-213-2071
Mailing Address - Fax:334-213-1195
Practice Address - Street 1:2680 BELL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-4375
Practice Address - Country:US
Practice Address - Phone:334-213-2071
Practice Address - Fax:334-213-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children