Healthcare Provider Details

I. General information

NPI: 1851794713
Provider Name (Legal Business Name): READY FOR LIFE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2014
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 28TH ST SE SUITE 102
GRAND RAPIDS MI
49512-1644
US

IV. Provider business mailing address

3250 28TH ST SE SUITE 102
GRAND RAPIDS MI
49512-1644
US

V. Phone/Fax

Practice location:
  • Phone: 616-248-3775
  • Fax: 616-419-4152
Mailing address:
  • Phone: 616-248-3775
  • Fax: 616-419-4152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number70704U
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: EMILY PERTON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 616-248-3775