Provider Demographics
NPI:1114116399
Name:HORSE SENSE FOR A 'CHANGE', LLC
Entity Type:Organization
Organization Name:HORSE SENSE FOR A 'CHANGE', LLC
Other - Org Name:MOVING SOLUTION LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:S
Authorized Official - Last Name:OBANNON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:520-260-2174
Mailing Address - Street 1:7301 E 22ND ST
Mailing Address - Street 2:SUITE 10E
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-6426
Mailing Address - Country:US
Mailing Address - Phone:520-260-2174
Mailing Address - Fax:520-296-0998
Practice Address - Street 1:7301 E 22ND ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-6426
Practice Address - Country:US
Practice Address - Phone:520-296-0442
Practice Address - Fax:520-296-0998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ41541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1710061189OtherORIGINAL INDIVIDUAL NPI
AZZ118600OtherMEDICARE PTAN