Provider Demographics
NPI:1033660642
Name:YOUTH FOR CHANGE
Entity Type:Organization
Organization Name:YOUTH FOR CHANGE
Other - Org Name:RIO TOWERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:MADISON
Authorized Official - Last Name:SILER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-877-8187
Mailing Address - Street 1:578 RIO LINDO AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1800
Mailing Address - Country:US
Mailing Address - Phone:530-894-5933
Mailing Address - Fax:530-894-5791
Practice Address - Street 1:572 RIO LINDO AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1851
Practice Address - Country:US
Practice Address - Phone:530-894-5933
Practice Address - Fax:530-894-5791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health