Provider Demographics
NPI:1659409233
Name:EQUINE ASSISTED THERAPY AT MOUNTAIN VALLEY
Entity Type:Organization
Organization Name:EQUINE ASSISTED THERAPY AT MOUNTAIN VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY AND TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-656-9447
Mailing Address - Street 1:524 LOMA ALTA RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-9432
Mailing Address - Country:US
Mailing Address - Phone:831-656-9447
Mailing Address - Fax:831-373-1944
Practice Address - Street 1:524 LOMA ALTA RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-9432
Practice Address - Country:US
Practice Address - Phone:831-656-9447
Practice Address - Fax:831-373-1944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center