Healthcare Provider Details

I. General information

NPI: 1427753581
Provider Name (Legal Business Name): ROCKY MOUNTAIN EQUINE ASSISTED PSYCHOTHERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 03/30/2023
Certification Date: 03/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7811 W TITAN RD
LITTLETON CO
80125-9527
US

IV. Provider business mailing address

9709 OXFORD RD
LONGMONT CO
80504-7708
US

V. Phone/Fax

Practice location:
  • Phone: 570-220-3016
  • Fax:
Mailing address:
  • Phone: 570-220-3016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANA SCHULTZ
Title or Position: CO-FOUNDER
Credential: LCSW
Phone: 570-220-3016