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General NPI Number Information
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NPI Number | 1568970077
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Entity Type | Organization
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Legal Business Name | CHALLENGED CHAMPIONS EQUESTRIAN CENTER, INC.
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Dates
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Enumeration Date | 01/18/2018
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Last Update Date | 01/18/2018
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Provider Practice Location Address
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Address Line | 11913 ROAD 6
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City | OTTAWA
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State | OH
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Zip | 45875
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Country | US
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Telephone | 419-456-3449
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Fax |
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Provider Business Mailing Address
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Address Line | 11913 ROAD 6
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City | OTTAWA
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State | OH
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Zip | 45875
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Country | US
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Telephone | 419-456-3449
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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 | MRS. LAURA LUGINBILL
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Credential |
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Telephone | 419-235-8930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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