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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