Healthcare Provider Details

I. General information

NPI: 1114221272
Provider Name (Legal Business Name): HOOFBEATS WITH HEART
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2011
Last Update Date: 01/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43491 N COYOTE RD
SAN TAN VALLEY AZ
85140-8924
US

IV. Provider business mailing address

PO BOX 2098
HIGLEY AZ
85236-2098
US

V. Phone/Fax

Practice location:
  • Phone: 602-421-7718
  • Fax: 480-888-0338
Mailing address:
  • Phone: 602-421-7718
  • Fax: 480-888-0343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MELANIE IRENE CONATSER
Title or Position: THERAPY DIRECTOR
Credential: OTR/L
Phone: 602-793-9676