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General NPI Number Information
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NPI Number | 1053669499
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Entity Type | Organization
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Legal Business Name | REACH OUT OF MONTGOMERY COUNTY, INC
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 08/15/2012
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Provider Practice Location Address
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Address Line | 25 E FORAKER ST
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City | DAYTON
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State | OH
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Zip | 45409-2918
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Country | US
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Telephone | 937-258-2000
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Fax | 937-424-2399
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Provider Business Mailing Address
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Address Line | 25 E FORAKER ST
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City | DAYTON
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State | OH
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Zip | 45409-2918
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Country | US
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Telephone | 937-258-2000
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Fax | 937-424-2399
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. SHARON J SHERLOCK
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Credential | RN, DHA
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Telephone | 937-258-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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