Provider Demographics
NPI:1881876928
Name:TIMOTHY HILL CHILDREN'S RANCH, INC.
Entity type:Organization
Organization Name:TIMOTHY HILL CHILDREN'S RANCH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DEVELOPMENT EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CLIFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-369-1234
Mailing Address - Street 1:298 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2034
Mailing Address - Country:US
Mailing Address - Phone:631-369-1234
Mailing Address - Fax:631-369-0130
Practice Address - Street 1:298 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2034
Practice Address - Country:US
Practice Address - Phone:631-369-1234
Practice Address - Fax:631-369-0130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable