MEDICARE: HOPE THRU HORSES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C005244	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295769149
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE THRU HORSES INC

Provider Business Mailing Address
First Line	:	1860 ARMORY RD
Second Line	:
City	:	PARKTON
State	:	NC
Zip	:	28371-8436
Country	:	US
Telephone Number	:	910-494-5888
Fax Number	:	910-920-9113

Provider Business Practice Location Address
First Line	:	1860 ARMORY RD
Second Line	:
City	:	PARKTON
State	:	NC
Zip	:	28371
Country	:	US
Telephone Number	:	910-494-5888
Fax Number	:	910-920-9113

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HEATHER MARIE WILKERSON
Credential	:	LCSW
Telephone Number	:	910-494-5888

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	09/06/2018

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