Provider Demographics
NPI:1053669499
Name:REACH OUT OF MONTGOMERY COUNTY, INC
Entity Type:Organization
Organization Name:REACH OUT OF MONTGOMERY COUNTY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHERLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:RN, DHA
Authorized Official - Phone:937-258-2000
Mailing Address - Street 1:25 E FORAKER ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2918
Mailing Address - Country:US
Mailing Address - Phone:937-258-2000
Mailing Address - Fax:937-424-2399
Practice Address - Street 1:25 E FORAKER ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2918
Practice Address - Country:US
Practice Address - Phone:937-258-2000
Practice Address - Fax:937-424-2399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable