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General NPI Number Information
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NPI Number | 1336946268
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Entity Type | Organization
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Legal Business Name | MEDICINE HORSE PROGRAM LLC
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 7663 E COUNTY LINE RD
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City | LONGMONT
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State | CO
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Zip | 80504-8430
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Country | US
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Telephone | 303-859-4883
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Fax |
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Provider Business Mailing Address
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Address Line | 7663 E COUNTY LINE RD
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City | LONGMONT
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State | CO
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Zip | 80504-8430
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Country | US
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Telephone | 303-859-4883
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. MICHAEL G FRANKLIN
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Credential |
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Telephone | 303-859-4883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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