Provider Demographics
| NPI: | 1174893309 |
|---|---|
| Name: | EQUINE PARTNERS UNLIMITED, INC. |
| Entity type: | Organization |
| Organization Name: | EQUINE PARTNERS UNLIMITED, INC. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | MRS |
| Authorized Official - First Name: | MARTHA |
| Authorized Official - Middle Name: | ANN |
| Authorized Official - Last Name: | BULSON |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | LSW |
| Authorized Official - Phone: | 614-565-7031 |
| Mailing Address - Street 1: | 7207 YOUNG RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | GROVE CITY |
| Mailing Address - State: | OH |
| Mailing Address - Zip Code: | 43123-9045 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 614-273-9918 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 7207 YOUNG RD |
| Practice Address - Street 2: | |
| Practice Address - City: | GROVE CITY |
| Practice Address - State: | OH |
| Practice Address - Zip Code: | 43123-9045 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 614-273-9918 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2012-01-04 |
| Last Update Date: | 2012-01-04 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| OH | S0017142 | 104100000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty |