Healthcare Provider Details

I. General information

NPI: 1932374048
Provider Name (Legal Business Name): HORSES OF HOPE RIDING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6968 SE 20TH ST
BAXTER SPRINGS KS
66713-3101
US

IV. Provider business mailing address

6968 SE 20TH ST
BAXTER SPRINGS KS
66713-3101
US

V. Phone/Fax

Practice location:
  • Phone: 620-674-3346
  • Fax: 620-674-3233
Mailing address:
  • Phone: 620-674-3346
  • Fax: 620-674-3233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MICHELE K MCCOLM
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 620-674-3346