Provider Demographics
NPI:1013064757
Name:COCHISE AREA NETWORK FOR THERAPEUTIC EQUESTRIAN RESOURCES
Entity Type:Organization
Organization Name:COCHISE AREA NETWORK FOR THERAPEUTIC EQUESTRIAN RESOURCES
Other - Org Name:C.A.N.T.E.R.
Other - Org Type:Other Name
Authorized Official - Title/Position:BOATD PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:A
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-366-0112
Mailing Address - Street 1:PO BOX 1316
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85636-1316
Mailing Address - Country:US
Mailing Address - Phone:520-378-3196
Mailing Address - Fax:
Practice Address - Street 1:7388 E CHIEF JOSEPH DR
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85650-8520
Practice Address - Country:US
Practice Address - Phone:520-378-3196
Practice Address - Fax:520-366-0038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty