Organization
PROSPECT MOUNTAIN THERAPEUTIC RIDING CENTER
Active
Organization
PROSPECT MOUNTAIN THERAPEUTIC RIDING CENTER
Active
Other names
PMTRC
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA RAE LISENBY INSTRUCTOR R.N. (INSTRUCTOR, CEO)
(469) 595-2019
Entity
Organization
Contact information
Practice address
7471 FM 3094, SCURRY, TX 75158-4915
(469) 595-2019
(972) 452-3331
Mailing address
7471 FM 3094, SCURRY, TX 75158-4915
(469) 595-2019
(972) 452-3331
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/30/2009
Last updated
05/30/2009
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