Provider Demographics
NPI:1831300979
Name:C.H.U.M. THERAPEUTIC RIDING, INC
Entity type:Organization
Organization Name:C.H.U.M. THERAPEUTIC RIDING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:DEPUE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:517-204-0974
Mailing Address - Street 1:PO BOX 14
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-0014
Mailing Address - Country:US
Mailing Address - Phone:517-204-0974
Mailing Address - Fax:517-623-0145
Practice Address - Street 1:2180 E DEXTER TRL
Practice Address - Street 2:
Practice Address - City:DANSVILLE
Practice Address - State:MI
Practice Address - Zip Code:48819-9781
Practice Address - Country:US
Practice Address - Phone:517-204-0974
Practice Address - Fax:517-623-0145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201005748174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty