Provider Demographics
NPI:1649767625
Name:TRINITY CIRCLE HORSES HEALING HEARTS
Entity Type:Organization
Organization Name:TRINITY CIRCLE HORSES HEALING HEARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWLAN
Authorized Official - Suffix:
Authorized Official - Credentials:ESMHL, ES4H
Authorized Official - Phone:417-455-1200
Mailing Address - Street 1:7370 MARTEN RD
Mailing Address - Street 2:
Mailing Address - City:NEOSHO
Mailing Address - State:MO
Mailing Address - Zip Code:64850-6581
Mailing Address - Country:US
Mailing Address - Phone:417-455-1200
Mailing Address - Fax:
Practice Address - Street 1:7370 MARTEN RD
Practice Address - Street 2:
Practice Address - City:NEOSHO
Practice Address - State:MO
Practice Address - Zip Code:64850-6581
Practice Address - Country:US
Practice Address - Phone:417-455-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251K00000XAgenciesPublic Health or Welfare
No251V00000XAgenciesVoluntary or Charitable
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1659829927OtherINDIVIDUAL NPI