Avalon Therapeutic Riding Stable

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

AVALON THERAPEUTIC RIDING STABLE

Practice address

11880 Mendenhall Loop Rd
Juneau, AK 99801-8662

Phone

(907) 500-2244

NPI assigned

Jan 26, 2010

Last updated

Jan 26, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Anne Patricia Blust

Title

Ceo

Phone

(907) 500-2244

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264464000000",
    "number": "1841521291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33053",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998033053",
            "telephone_number": "907-500-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11880 MENDENHALL LOOP RD",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998018662",
            "telephone_number": "907-500-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON THERAPEUTIC RIDING STABLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-26",
        "last_updated": "2010-01-26",
        "status": "A",
        "authorized_official_last_name": "BLUST",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-500-2244",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.