# ROCKING HORSE RANCH AFC HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689814063
- **Authorized official:** MRS. MOONYEEN L. LINCOLN (OWNER)
- **Authorized official phone:** (616) 846-6593

## Contact information

- **Practice address:** 19138 144TH AVE, FRUITPORT, MI 49415-9670
- **Practice address phone:** (616) 846-6593
- **Mailing address:** 19138 144TH AVE, FRUITPORT, MI 49415-9670
- **Mailing address phone:** (616) 846-6593

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | AF700237485 | MI | Yes |

## Other

- **Enumeration date:** 02/25/2009
- **Last updated:** 02/25/2009