Healthcare Provider Details

I. General information

NPI: 1164791174
Provider Name (Legal Business Name): TURN AROUND RANCH THERAPEUTIC RIDING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2011
Last Update Date: 12/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 SE 1201ST RD
CLINTON MO
64735-9391
US

IV. Provider business mailing address

PO BOX 693
CLINTON MO
64735
US

V. Phone/Fax

Practice location:
  • Phone: 660-492-9072
  • Fax:
Mailing address:
  • Phone: 660-492-9072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. WENDY LEA THON
Title or Position: INSTRUCTOR/THERAPIST
Credential: NAHRA CERTIFIED
Phone: 660-492-9072