Healthcare Provider Details

I. General information

NPI: 1992236871
Provider Name (Legal Business Name): R.E.A.C.H. PROJECT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2017
Last Update Date: 03/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 HARBOR ST
PITTSBURG CA
94565-4615
US

IV. Provider business mailing address

1915 D ST
ANTIOCH CA
94509-2571
US

V. Phone/Fax

Practice location:
  • Phone: 925-473-2390
  • Fax: 925-754-2002
Mailing address:
  • Phone: 925-754-3673
  • Fax: 925-754-2002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MICKIE ANGELO MARCHETTI
Title or Position: EXECUTIVE DIRECTOR
Credential: M.A.
Phone: 925-779-6908