| Ready To Heal/grow | |
|
4111 Black Pine Rd Cottonwood CA 96022-9116 | |
| (530) 803-3223 | |
| Not Available |
| Full Name | Ready To Heal/grow |
|---|---|
| Speciality | Social Worker |
| Location | 4111 Black Pine Rd, Cottonwood, California |
| Authorized Official Name and Position | Heather L. Mauldin (OWNER) |
| Authorized Official Contact | 5308033223 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ready To Heal/grow 4111 Black Pine Rd Cottonwood CA 96022-9116 Ph: (530) 803-3223 | Ready To Heal/grow 4111 Black Pine Rd Cottonwood CA 96022-9116 Ph: (530) 803-3223 |
| NPI Number | 1639931819 |
|---|---|
| Provider Enumeration Date | 01/24/2024 |
| Last Update Date | 03/06/2024 |
| Certification Date | 03/06/2024 |
| Medicare PECOS PAC ID | 1759729890 |
|---|---|
| Medicare Enrollment ID | O20240409001095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639931819 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Heather Mauldin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588835458 PECOS PAC ID: 9335404342 Enrollment ID: I20180522002261 |
Youth Service Agency Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 19786 Big Bend Dr, Cottonwood, CA 96022 Phone: 530-347-5913 |