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General NPI Number Information
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NPI Number | 1215759402
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Entity Type | Organization
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Legal Business Name | REALITY OUTREACH INC
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 330 ROBERTS ST STE 103
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City | EAST HARTFORD
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State | CT
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Zip | 06108-3654
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Country | US
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Telephone | 860-962-1803
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Fax | 203-590-1197
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Provider Business Mailing Address
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Address Line | 57 BROOKWOOD DR
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City | ROCKY HILL
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State | CT
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Zip | 06067-2723
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Country | US
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Telephone | 860-962-1803
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Fax | 203-590-1197
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ROSA L SMITH
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Credential |
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Telephone | 860-962-1803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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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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