Provider Demographics
NPI:1134692098
Name:HEALING HOOFBEATS OF CT, INC
Entity Type:Organization
Organization Name:HEALING HOOFBEATS OF CT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUFFARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-459-4115
Mailing Address - Street 1:94 ISAIAH SMITH LANE
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:CT
Mailing Address - Zip Code:06763-1506
Mailing Address - Country:US
Mailing Address - Phone:860-459-4115
Mailing Address - Fax:860-733-0323
Practice Address - Street 1:94 ISAIAH SMITH LANE
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:CT
Practice Address - Zip Code:06763-1506
Practice Address - Country:US
Practice Address - Phone:860-459-4115
Practice Address - Fax:860-733-0323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty