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General NPI Number Information
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NPI Number | 1700224276
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Entity Type | Organization
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Legal Business Name | RANCHO ESCONDIDO THERAPEUTIC RIDING & EQUINE ASSISTED THERAPY, INC.
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Dates
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Enumeration Date | 06/06/2013
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Last Update Date | 02/25/2019
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Provider Practice Location Address
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Address Line | 5386 SANTA TERESITA DR
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City | SANTA TERESA
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State | NM
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Zip | 88008-9204
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Country | US
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Telephone | 575-332-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 5386 SANTA TERESITA DR
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City | SANTA TERESA
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State | NM
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Zip | 88008-9204
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Country | US
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Telephone | 575-332-4111
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Fax |
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Authorized Official
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Title or Position | CONTACT
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Name | MR. LESTER HIRSCH
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Credential |
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Telephone | 915-731-2785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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