NPI 1639225667

Judge James V Riddel Boys Ranch

Organisation Psychiatric Residential Treatment Facility Goddard, KS

Practice location

Address: 25331 W 39th St S, Goddard, KS 67052-9244
Phone: (316) 660-1600
Fax: (316) 794-2061
Mailing address: 700 S Hydraulic St, Wichita, KS 67211-2704

Authorised official

Name: Mark Masterson
Title: Director of Corrections
Phone: (316) 660-9750

Registered specialties

Psychiatric Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 323P00000X Licence 0003181-001 (KS)

Other Psychiatric Residential Treatment Facility providers in Kansas →

Registry record

NPI: 1639225667
Entity type: Organization
NPI issued: 25 Jan 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.