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General NPI Number Information
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NPI Number | 1194952390
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Entity Type | Organization
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Legal Business Name | HORSES & HOPE EQUINE EMPOWERMENT PROGRAM
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Dates
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Enumeration Date | 06/15/2009
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Last Update Date | 06/15/2009
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Provider Practice Location Address
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Address Line | 110 GREEN MEADOW LN
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City | FAYETTEVILLE
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State | GA
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Zip | 30215-6503
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Country | US
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Telephone | 404-557-8931
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Fax |
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Provider Business Mailing Address
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Address Line | 1607 CASCADE OVERLOOK
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-3066
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Country | US
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Telephone | 678-364-9021
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. NAOMI L DUNCAN
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Credential | LCSW
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Telephone | 404-557-8931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | CSW003694
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License Number State | GA
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