Provider Demographics
NPI:1528330974
Name:HORTICULTURE THERAPY FARM, LLC
Entity type:Organization
Organization Name:HORTICULTURE THERAPY FARM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:LADC, LPC, LMHC
Authorized Official - Phone:203-815-8260
Mailing Address - Street 1:POST OFFICE BOX 284
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-0284
Mailing Address - Country:US
Mailing Address - Phone:203-815-8260
Mailing Address - Fax:203-298-4245
Practice Address - Street 1:374 E. LITCHFIELD RD.
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-2901
Practice Address - Country:US
Practice Address - Phone:203-815-8267
Practice Address - Fax:203-298-4245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008008097Medicaid