Provider Demographics
NPI:1356913750
Name:ENVISION THERAPEUTIC HORSEMANSHIP, INC.
Entity type:Organization
Organization Name:ENVISION THERAPEUTIC HORSEMANSHIP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CARL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:602-930-5143
Mailing Address - Street 1:4900 E THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-7807
Mailing Address - Country:US
Mailing Address - Phone:480-262-3434
Mailing Address - Fax:602-687-7069
Practice Address - Street 1:4900 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-7807
Practice Address - Country:US
Practice Address - Phone:480-262-3434
Practice Address - Fax:602-687-7069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health