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General NPI Number Information
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NPI Number | 1720458854
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Entity Type | Organization
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Legal Business Name | R.E.A.C.H. PEDIATRIC HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 10/01/2015
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Last Update Date | 10/01/2015
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Provider Practice Location Address
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Address Line | 610 HWY 5 N
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City | BENTON
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State | AR
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Zip | 72019-8559
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Country | US
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Telephone | 501-794-2269
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Fax | 501-794-2229
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Provider Business Mailing Address
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Address Line | 610 HWY 5 N
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City | BENTON
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State | AR
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Zip | 72019-8559
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Country | US
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Telephone | 501-794-2269
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Fax | 501-794-2229
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. REBEKAH JAMES
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Credential | M.S., CCC-SLP
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Telephone | 501-794-2269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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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 #5
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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