Provider Demographics
NPI:1033736491
Name:X CHANGE RECOVERY
Entity Type:Organization
Organization Name:X CHANGE RECOVERY
Other - Org Name:XCHANGE BEHAVIORAL HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-777-9242
Mailing Address - Street 1:21810 NE 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:98642-7747
Mailing Address - Country:US
Mailing Address - Phone:844-777-9242
Mailing Address - Fax:360-397-7477
Practice Address - Street 1:21810 NE 37TH AVE
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:WA
Practice Address - Zip Code:98642-7747
Practice Address - Country:US
Practice Address - Phone:844-777-9242
Practice Address - Fax:360-397-7477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty