Provider Demographics
NPI:1962250951
Name:BLUFF AND RIDGE EQUINE ASSISTED THERAPIES, INC.
Entity type:Organization
Organization Name:BLUFF AND RIDGE EQUINE ASSISTED THERAPIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-343-7740
Mailing Address - Street 1:30662 MOCCASIN AVE
Mailing Address - Street 2:
Mailing Address - City:KENDALL
Mailing Address - State:WI
Mailing Address - Zip Code:54638-7052
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:28464 MONARCH AVE
Practice Address - Street 2:
Practice Address - City:KENDALL
Practice Address - State:WI
Practice Address - Zip Code:54638-7076
Practice Address - Country:US
Practice Address - Phone:608-343-7740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable