Provider Demographics
NPI:1548496086
Name:COURAGE TO CHANGE RANCHES
Entity type:Organization
Organization Name:COURAGE TO CHANGE RANCHES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-541-4912
Mailing Address - Street 1:41250 ALFORD RD
Mailing Address - Street 2:
Mailing Address - City:SIMLA
Mailing Address - State:CO
Mailing Address - Zip Code:80835-9607
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:41250 ALFORD ROAD
Practice Address - Street 2:
Practice Address - City:SIMLA
Practice Address - State:CO
Practice Address - Zip Code:80835
Practice Address - Country:US
Practice Address - Phone:719-541-4912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility