Healthcare Provider Details

I. General information

NPI: 1508728114
Provider Name (Legal Business Name): READY FOR LIFE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1741 W ORAIBI DR
PHOENIX AZ
85027-4506
US

IV. Provider business mailing address

10810 N TATUM BLVD STE 102-211
PHOENIX AZ
85028-6055
US

V. Phone/Fax

Practice location:
  • Phone: 602-607-5522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: ZAC LANE
Title or Position: ADMINISTRATOR
Credential:
Phone: 602-821-5299