Provider Demographics
NPI:1164081063
Name:REYNOLDS BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:REYNOLDS BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THEODOR
Authorized Official - Middle Name:B
Authorized Official - Last Name:RAIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-754-4494
Mailing Address - Street 1:1649 N REYNOLDS RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-3625
Mailing Address - Country:US
Mailing Address - Phone:419-754-4494
Mailing Address - Fax:419-754-6217
Practice Address - Street 1:1649 N REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-3625
Practice Address - Country:US
Practice Address - Phone:419-754-4494
Practice Address - Fax:419-754-6217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty