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General NPI Number Information
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NPI Number | 1285422089
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Entity Type | Organization
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Legal Business Name | GUARDIAN 4 HEROES
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 310 US 71 N
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City | SAUK CENTRE
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State | MN
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Zip | 56378-1144
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Country | US
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Telephone | 320-828-2477
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Fax |
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Provider Business Mailing Address
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Address Line | 24 FAIRY LAKE RD
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City | SAUK CENTRE
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State | MN
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Zip | 56378-1901
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Country | US
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Telephone | 320-828-2477
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/EXC DIRECTOR/FACILITATOR
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Name | MS. SARA AMANDA PETERSON
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Credential | EFPT EQUINE THERAPY
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Telephone | 320-828-2477
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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 |
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License Number State |
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