Provider Demographics
NPI:1033543616
Name:SOUTHERN VERMONT THERAPEUTIC RIDING CENTER
Entity Type:Organization
Organization Name:SOUTHERN VERMONT THERAPEUTIC RIDING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/INSTRUCTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-221-4409
Mailing Address - Street 1:336 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:NEWFANE
Mailing Address - State:VT
Mailing Address - Zip Code:05345-9667
Mailing Address - Country:US
Mailing Address - Phone:802-221-4409
Mailing Address - Fax:
Practice Address - Street 1:336 RIVER RD
Practice Address - Street 2:
Practice Address - City:NEWFANE
Practice Address - State:VT
Practice Address - Zip Code:05345-9667
Practice Address - Country:US
Practice Address - Phone:802-221-4409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy