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General NPI Number Information
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NPI Number | 1811533763
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Entity Type | Organization
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Legal Business Name | READY FOR CHANGE
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Dates
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Enumeration Date | 11/25/2019
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 510 SOUTH 10TH STREET UNIT A
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City | LAS VEGAS
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State | NV
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Zip | 89101-7874
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Country | US
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Telephone | 702-462-6630
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Fax |
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Provider Business Mailing Address
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Address Line | 510 SOUTH 10TH STREET UNIT A
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City | LAS VEGAS
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State | NV
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Zip | 89101-7874
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Country | US
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Telephone | 702-462-6630
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | SHANISE MARIE ALEXANDER
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Credential |
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Telephone | 800-207-1565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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