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General NPI Number Information
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NPI Number | 1003797242
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE RANCH EQUINE THERAPY CENTER INC
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2320 WATER PLANT RD
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-9249
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Country | US
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Telephone | 904-487-9986
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Fax |
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Provider Business Mailing Address
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Address Line | 7451 ORTEGA HILLS DR
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City | JACKSONVILLE
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State | FL
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Zip | 32244-4633
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Country | US
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Telephone | 904-487-9986
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Fax |
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Authorized Official
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Title or Position | EQUINE THERAPIST
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Name | ALEXANDRIA JONES
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Credential | ES, CTAA
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Telephone | 904-487-9986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State |
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