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General NPI Number Information
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NPI Number | 1215051388
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Entity Type | Organization
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Legal Business Name | REACH, INC.
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 213 3RD ST
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City | JUNEAU
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State | AK
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Zip | 99801-1220
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Country | US
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Telephone | 907-586-8228
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Fax | 907-586-8226
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Provider Business Mailing Address
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Address Line | 213 3RD ST
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City | JUNEAU
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State | AK
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Zip | 99801-1220
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Country | US
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Telephone | 907-586-8228
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Fax | 907-586-8226
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | RICHARD FAGUNDES
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Credential |
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Telephone | 907-586-8228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | HC7127
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | HC7127
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License Number State | AK
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