Healthcare Provider Details

I. General information

NPI: 1811159668
Provider Name (Legal Business Name): YOUTH FOR CHANGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 09/30/2020
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 W 6TH ST
CHICO CA
95928-5508
US

IV. Provider business mailing address

PO BOX 1476
PARADISE CA
95967-1476
US

V. Phone/Fax

Practice location:
  • Phone: 530-894-8008
  • Fax: 530-894-8222
Mailing address:
  • Phone: 530-877-8187
  • Fax: 530-894-5791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. BETH PARSONS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 530-877-8187