Provider Demographics
NPI:1962015339
Name:READY FOR CHANGE, INC.
Entity Type:Organization
Organization Name:READY FOR CHANGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:208-329-6647
Mailing Address - Street 1:322 E. MAIN ST.
Mailing Address - Street 2:PMB 218
Mailing Address - City:BURLEY
Mailing Address - State:ID
Mailing Address - Zip Code:83318-1933
Mailing Address - Country:US
Mailing Address - Phone:208-329-6647
Mailing Address - Fax:
Practice Address - Street 1:1373 FILLMORE ST
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3392
Practice Address - Country:US
Practice Address - Phone:208-737-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health