Healthcare Provider Details

I. General information

NPI: 1710612817
Provider Name (Legal Business Name): REACHING BEYOND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7940 N SCHOLES AVE
TUCSON AZ
85741-1492
US

IV. Provider business mailing address

14047 W MONTE VISTA RD
GOODYEAR AZ
85395-5714
US

V. Phone/Fax

Practice location:
  • Phone: 480-437-0082
  • Fax:
Mailing address:
  • Phone: 480-437-0082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: RANDY JEROME BLAND
Title or Position: CEO
Credential:
Phone: 480-437-0082