Provider Demographics
NPI:1700224276
Name:RANCHO ESCONDIDO THERAPEUTIC RIDING & EQUINE ASSISTED THERAPY, INC.
Entity Type:Organization
Organization Name:RANCHO ESCONDIDO THERAPEUTIC RIDING & EQUINE ASSISTED THERAPY, INC.
Other - Org Name:RETREAT
Other - Org Type:Other Name
Authorized Official - Title/Position:CONTACT
Authorized Official - Prefix:MR
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-731-2785
Mailing Address - Street 1:5386 SANTA TERESITA DR
Mailing Address - Street 2:
Mailing Address - City:SANTA TERESA
Mailing Address - State:NM
Mailing Address - Zip Code:88008-9204
Mailing Address - Country:US
Mailing Address - Phone:575-332-4111
Mailing Address - Fax:
Practice Address - Street 1:5386 SANTA TERESITA DR
Practice Address - Street 2:
Practice Address - City:SANTA TERESA
Practice Address - State:NM
Practice Address - Zip Code:88008-9204
Practice Address - Country:US
Practice Address - Phone:575-332-4111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-06
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No251300000XAgenciesLocal Education Agency (LEA)
No251S00000XAgenciesCommunity/Behavioral Health