Provider Demographics
NPI:1962521245
Name:CHALLENGE TO CHANGE INC
Entity type:Organization
Organization Name:CHALLENGE TO CHANGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:580-231-0878
Mailing Address - Street 1:502 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-5630
Mailing Address - Country:US
Mailing Address - Phone:580-234-2901
Mailing Address - Fax:580-234-0086
Practice Address - Street 1:306 W STATE AVE
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-7216
Practice Address - Country:US
Practice Address - Phone:580-234-2901
Practice Address - Fax:580-234-0086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty