| Ready 4 Change | |
|
325 W Hospitality Ln Ste 110 San Bernardino CA 92408-3210 | |
| (909) 581-4854 | |
| Not Available |
| Full Name | Ready 4 Change |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 325 W Hospitality Ln Ste 110, San Bernardino, California |
| Authorized Official Name and Position | Monique Roach (AUTHORIZED REPRESENTATIVE) |
| Authorized Official Contact | 9095814854 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ready 4 Change 25920 Iris Ave Ste 13a #209 Moreno Valley CA 92551-1658 Ph: (909) 581-4854 | Ready 4 Change 325 W Hospitality Ln Ste 110 San Bernardino CA 92408-3210 Ph: (909) 581-4854 |
| NPI Number | 1356925531 |
|---|---|
| Provider Enumeration Date | 05/12/2021 |
| Last Update Date | 02/26/2023 |
| Certification Date | 02/26/2023 |
| Medicare PECOS PAC ID | 2163879370 |
|---|---|
| Medicare Enrollment ID | O20231109002206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356925531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Monique N Roach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144781733 PECOS PAC ID: 3971837972 Enrollment ID: I20190625003046 |
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