Provider Demographics
NPI:1114672789
Name:EUDAEMONIA EQUINE CONNECTIONS, INC.
Entity type:Organization
Organization Name:EUDAEMONIA EQUINE CONNECTIONS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:WARA-GOSS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, PHD
Authorized Official - Phone:503-862-7906
Mailing Address - Street 1:515 NW SALTZMAN RD # 744
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-6098
Mailing Address - Country:US
Mailing Address - Phone:503-862-7906
Mailing Address - Fax:971-404-2460
Practice Address - Street 1:515 NW SALTZMAN RD #744
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229
Practice Address - Country:US
Practice Address - Phone:503-862-7906
Practice Address - Fax:971-404-2460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-13
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1851674451OtherNPI