Provider Demographics
NPI:1679764898
Name:HEALING PARTNERS EQUESTRIAN PROGRAM
Entity type:Organization
Organization Name:HEALING PARTNERS EQUESTRIAN PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:RAND
Authorized Official - Last Name:GURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-263-5393
Mailing Address - Street 1:506 N 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-1513
Mailing Address - Country:US
Mailing Address - Phone:208-263-5393
Mailing Address - Fax:
Practice Address - Street 1:1605 HOODOO MT. ROAD
Practice Address - Street 2:
Practice Address - City:PRIEST RIVER
Practice Address - State:ID
Practice Address - Zip Code:83856
Practice Address - Country:US
Practice Address - Phone:208-263-9076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-1358251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health