Provider Demographics
NPI:1396473815
Name:HOOFPRINTS IN THE SAND, INC.
Entity type:Organization
Organization Name:HOOFPRINTS IN THE SAND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHAB NURSE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:KENNERLY
Authorized Official - Last Name:LUSTIG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:843-364-4918
Mailing Address - Street 1:8 INTRACOASTAL CT
Mailing Address - Street 2:
Mailing Address - City:ISLE OF PALMS
Mailing Address - State:SC
Mailing Address - Zip Code:29451-2500
Mailing Address - Country:US
Mailing Address - Phone:843-364-4918
Mailing Address - Fax:
Practice Address - Street 1:1131 WANDO RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29492-7854
Practice Address - Country:US
Practice Address - Phone:843-364-4918
Practice Address - Fax:843-884-4618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty