Healthcare Provider Details

I. General information

NPI: 1437837721
Provider Name (Legal Business Name): REACHING HANDS BEHAVIORAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2023
Last Update Date: 07/07/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 LAKE SHADOW CIR APT 10303
MAITLAND FL
32751-7586
US

IV. Provider business mailing address

1400 LAKE SHADOW CIR APT 10303
MAITLAND FL
32751-7586
US

V. Phone/Fax

Practice location:
  • Phone: 321-203-9018
  • Fax:
Mailing address:
  • Phone: 321-203-9018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: SANDRINE N AMEGNISSE
Title or Position: MANAGER
Credential:
Phone: 321-203-9018