Provider Demographics
NPI:1154994242
Name:SUMMIT EQUINE THERAPY LLC
Entity type:Organization
Organization Name:SUMMIT EQUINE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LIMHP
Authorized Official - Prefix:
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SASS
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP
Authorized Official - Phone:402-540-3755
Mailing Address - Street 1:700 190TH ST
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:NE
Mailing Address - Zip Code:68347-1708
Mailing Address - Country:US
Mailing Address - Phone:402-540-3755
Mailing Address - Fax:
Practice Address - Street 1:700 190TH ST
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:NE
Practice Address - Zip Code:68347-1708
Practice Address - Country:US
Practice Address - Phone:402-540-3755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty