Provider Demographics
NPI:1174221915
Name:READY PEER SUPPORT
Entity type:Organization
Organization Name:READY PEER SUPPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TEVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ADULARESCENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-913-6148
Mailing Address - Street 1:1228 WALNUT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-7135
Mailing Address - Country:US
Mailing Address - Phone:513-913-6148
Mailing Address - Fax:
Practice Address - Street 1:800 VINE ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-2009
Practice Address - Country:US
Practice Address - Phone:513-913-6148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2024-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health