Organization
EQUINE ESCAPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MANSER (VICE PRESIDENT)
(248) 802-2608
Entity
Organization
Contact information
Practice address
5880 BRIGHAM RD, GOODRICH, MI 48438-9645
(810) 287-0519
Mailing address
5880 BRIGHAM RD, GOODRICH, MI 48438-9645
(810) 287-0519
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
Primary
—
—
305S00000X
Point of Service
—
—
Other
Enumeration date
09/09/2024
Last updated
09/26/2024
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