Eagle Vista Equine Center, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

01258 Issued in MN

Legal business name

EAGLE VISTA EQUINE CENTER, INC.

Practice address

16150 Golden Eagle CT NW
Bemidji, MN 56601-7111

Phone

(218) 760-0656

NPI assigned

Sep 11, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Elizabeth Anne Letson, MS, LPCNPI 1790029924

Title

Owner/Founder and LPC

Phone

(218) 760-0656

Specialties & licenses 1

Addresses

Other names 1

• Eagle Vista Ranch Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth Anne Letson, M.S., L.P.C

  • Professional Counselor
  • Bemidji, MN
  • NPI 1790029924
  NPD (past) Authorized official
• Angela Krom Fournier, PH.D., L.P.

  • Clinical Psychologist
  • Bemidji, MN
  • NPI 1619367919
  NPD (past)

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410393600000",
    "number": "1861893547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16150 GOLDEN EAGLE CT NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566017111",
            "telephone_number": "218-760-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16150 GOLDEN EAGLE CT NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566017111",
            "telephone_number": "218-760-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE VISTA EQUINE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-11",
        "last_updated": "2014-09-11",
        "status": "A",
        "authorized_official_last_name": "LETSON",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER/FOUNDER AND LPC",
        "authorized_official_telephone_number": "218-760-0656",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "01258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Vista Ranch",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Franklin G. Drucker, MD
• Arlene Duff
• Kelly Dunsmore, DPT
• Darice Diane Dwyer, PHN
• Mark S Dwyer, MD
• Zabrina Ebert, DO
• Edlund Chiropractic
• Joseph Wade Edlund, D.C.
• Timothy Joseph Edmiston, M.D.
• Robert A Edwards, O.D.

• Community/Behavioral Health Agency in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; 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.