Provider Demographics
NPI:1013442821
Name:RIDE-ON RANCH EQUINE ASSISTED THERAPIES
Entity Type:Organization
Organization Name:RIDE-ON RANCH EQUINE ASSISTED THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AUTUMN
Authorized Official - Middle Name:
Authorized Official - Last Name:O'HARA
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:703-298-5319
Mailing Address - Street 1:38416 MORRISONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LOVETTSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20180-3102
Mailing Address - Country:US
Mailing Address - Phone:703-298-5319
Mailing Address - Fax:
Practice Address - Street 1:38416 MORRISONVILLE RD
Practice Address - Street 2:
Practice Address - City:LOVETTSVILLE
Practice Address - State:VA
Practice Address - Zip Code:20180-3102
Practice Address - Country:US
Practice Address - Phone:703-298-5319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-30
Last Update Date:2017-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119005637261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service