GOOD SAMARITAN BOYS RANCH (NPI# 1679771430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679771430 |
| Entity Type | Organization |
| Organization Name | GOOD SAMARITAN BOYS RANCH |
| Practice Address |
5549 N Highway 13 Brighton MO 65617-8112 |
| Mailing Address |
Po Box 617 Brighton MO 65617-0617 |
| Practice Telephone | 4173762238 |
| Mailing Telephone | 4173762238 |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. ANGELA SICELUFF (DIRECTOR OF SOCIAL SERVICES) |
| Authorized Official Telephone | 4173762238 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | GOOD SAMARITAN BOYS RANCH | 5549 Highway K, Brighton, MO 65617-8112 |
| Street Address |
5549 N HIGHWAY 13 |
| City | BRIGHTON |
| State | MO |
| Zip Code | 65617-8112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801965512 | Matthew Joseph Moncado | Counselor | 5549 N Highway 13, Brighton, MO 65617-8112 | 2006-11-07 |
| 1609047653 | Lindsay M Wray | Social Worker | 5549 N Highway 13, Brighton, MO 65617-8112 | 2008-03-18 |
| 1023210846 | Tabitha Lee Klessens | Social Worker | 5549 N Highway 13, Brighton, MO 65617-8112 | 2007-06-04 |
| 1083823371 | Tracey Enochs | Counselor | 5549 N Highway 13, Brighton, MO 65617-8112 | 2007-05-22 |
| 1962619809 | Melissa Marie Jenkins | Counselor | 5549 N Highway 13, Brighton, MO 65617-8112 | 2007-05-17 |
| 1205043866 | Sarah Elizabeth Chadwick | Counselor | 5549 N Highway 13, Brighton, MO 65617-8112 | 2007-05-16 |
| 1154538767 | Amanda Elizabeth Griffin | Counselor | 5549 N Highway 13, Brighton, MO 65617-8112 | 2007-05-16 |
| 1275740730 | Geraldine V Miller | Social Worker | 5549 N Highway 13, Brighton, MO 65617-8112 | 2007-05-16 |
| 1134336829 | Angela Siceluff | Social Worker | 5549 N Highway 13, Brighton, MO 65617-8112 | 2007-05-16 |
| 1780891366 | Dixie D Deal | Counselor | 5549 N Highway 13, Brighton, MO 65617-8112 | 2007-05-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528426749 | Gail Lee Sanchez | Counselor | 5586 S 154th Rd, Brighton, MO 65617 | 2016-02-02 |
| 1275966400 | Ronald Delos Bauder Jr. | Social Worker | 5549 Highway K Old Highway 13, Good Samaritan Boys Ranch, Brighton, MO 65617 | 2013-08-12 |
| 1467750877 | Joel R Stewart | Counselor | 5549 Highway K, Brighton, MO 65617-7256 | 2011-03-09 |
| 1871147470 | Sue Ane Robinson | Counselor | 5549 Highway K, Brighton, MO 65617-7256 | 2019-07-31 |
| 1306490909 | Jenna Engler | Counselor | 5549 Highway K, Brighton, MO 65617-7256 | 2019-07-31 |
| 1306249016 | James Lowery | Counselor | 5549 Highway K, Brighton, MO 65617-7256 | 2014-10-08 |
| 1427302108 | Nicole Pingel | Counselor | 5549 Highway K, Brighton, MO 65617-7256 | 2012-11-02 |
| 1841543188 | Alissa Cara Jecklin | Social Worker | 5549 Highway K, Brighton, MO 65617-7256 | 2012-10-24 |
| 1003195462 | Leslie A Sawyer | Social Worker | 5549 Highway K, Brighton, MO 65617-7256 | 2011-08-16 |
| 1942649926 | K Webb Counseling Services, LLC | Counselor | 3160 W Eagle Ln, Brighton, MO 65617-8119 | 2013-06-23 |
| Find all providers in zip 65617 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609474204 | Whetstone Boys Ranch | Residential Treatment Facility, Emotionally Disturbed Children | 6850 County Road 2660, Mountain View, MO 65548-8146 | 2020-10-15 |
| 1962995993 | The Bridge Home for Children | Residential Treatment Facility, Emotionally Disturbed Children | 6033 Swope Pkwy, Kansas City, MO 64130-4461 | 2018-06-13 |
| 1437675477 | Kybama, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 12729 Stoney Point Rd, Bonne Terre, MO 63628 | 2017-08-22 |
| 1568914927 | Clear Creek Counseling | Residential Treatment Facility, Emotionally Disturbed Children | 3646 N Farm Road 89, Willard, MO 65781-8330 | 2016-11-01 |
| 1619330578 | Farmer Grove Homesteads Incorporated | Residential Treatment Facility, Emotionally Disturbed Children | 533 E Bedford St, Marshfield, MO 65706-1218 | 2016-03-29 |
| 1720447212 | Corner Stones of Care | Residential Treatment Facility, Emotionally Disturbed Children | 300 E 36th St, Kansas City, MO 64111-1410 | 2016-02-12 |
| 1558729509 | Cayman's House of Hope, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 311 N Poplar St, Fair Play, MO 65649-9299 | 2016-02-05 |
| 1639503691 | Proverb Academy, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 420 Carroll St, Morehouse, MO 63868 | 2013-08-27 |
| 1306147277 | Fair Haven Children's Home | Residential Treatment Facility, Emotionally Disturbed Children | 3132 N Fair Haven Loop, Strafford, MO 65757-8619 | 2010-11-09 |
| 1437470184 | Ozarks Teen Challenge | Residential Treatment Facility, Emotionally Disturbed Children | 512 Purist Lane, Branson West, MO 65737 | 2010-06-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.