Provider Demographics
NPI:1285380956
Name:HEARTS TO HORSES
Entity type:Organization
Organization Name:HEARTS TO HORSES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:AULT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-353-2838
Mailing Address - Street 1:12768 S CLOVERDALE RD
Mailing Address - Street 2:
Mailing Address - City:KUNA
Mailing Address - State:ID
Mailing Address - Zip Code:83634-2520
Mailing Address - Country:US
Mailing Address - Phone:208-353-2838
Mailing Address - Fax:
Practice Address - Street 1:12768 S CLOVERDALE RD
Practice Address - Street 2:
Practice Address - City:KUNA
Practice Address - State:ID
Practice Address - Zip Code:83634-2520
Practice Address - Country:US
Practice Address - Phone:208-353-2838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health