Provider Demographics
NPI:1316476864
Name:CHANGING GAITS INC.
Entity type:Organization
Organization Name:CHANGING GAITS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NILES
Authorized Official - Middle Name:GUY
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:EQUINE SPECIALIST
Authorized Official - Phone:320-438-4001
Mailing Address - Street 1:27274 MONUMENT RD
Mailing Address - Street 2:
Mailing Address - City:BROOK PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55007-2196
Mailing Address - Country:US
Mailing Address - Phone:320-438-4001
Mailing Address - Fax:320-438-2252
Practice Address - Street 1:27274 MONUMENT RD
Practice Address - Street 2:
Practice Address - City:BROOK PARK
Practice Address - State:MN
Practice Address - Zip Code:55007-2196
Practice Address - Country:US
Practice Address - Phone:320-438-4001
Practice Address - Fax:320-438-2252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable