Provider Demographics
NPI:1801620174
Name:PEGASUS SPRINGS THERAPEUTIC RIDING CENTER
Entity type:Organization
Organization Name:PEGASUS SPRINGS THERAPEUTIC RIDING CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CLARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-820-1787
Mailing Address - Street 1:4800 OLD STATE RD
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48748-9644
Mailing Address - Country:US
Mailing Address - Phone:989-820-1787
Mailing Address - Fax:
Practice Address - Street 1:4800 OLD STATE RD
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:MI
Practice Address - Zip Code:48748-9644
Practice Address - Country:US
Practice Address - Phone:989-820-1787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-29
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health