1326333857 NPI number — CARLISLE ACADEMY INTEGRATIVE EQUINE THERAPY AND SPORTS, LLC

Table of content: (NPI 1326333857)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326333857 NPI number — CARLISLE ACADEMY INTEGRATIVE EQUINE THERAPY AND SPORTS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARLISLE ACADEMY INTEGRATIVE EQUINE THERAPY AND SPORTS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326333857
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
65 DROWN LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LYMAN
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04002-6027
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-985-0374
Provider Business Mailing Address Fax Number:
207-985-7937

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
65 DROWN LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LYMAN
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04002-6027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-985-0374
Provider Business Practice Location Address Fax Number:
207-985-7937
Provider Enumeration Date:
06/13/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ARMENTROUT
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
CHAPPELL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
207-985-0374

Provider Taxonomy Codes

  • Taxonomy code: 224Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251G0304X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251P0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XF0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XN1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XP0019X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XP0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QX0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)