Provider Demographics
NPI:1932752730
Name:HORSEPLAY THERAPY CENTER
Entity Type:Organization
Organization Name:HORSEPLAY THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARREGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-315-8525
Mailing Address - Street 1:3533 CAROLWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-4320
Mailing Address - Country:US
Mailing Address - Phone:904-315-8525
Mailing Address - Fax:
Practice Address - Street 1:1925 STATE ROAD 207
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-9325
Practice Address - Country:US
Practice Address - Phone:904-315-8525
Practice Address - Fax:904-794-6917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-20
Last Update Date:2019-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty