Provider Demographics
NPI:1194366153
Name:REACHING HANDS AS EACH ONE TEACHINGS ONE
Entity Type:Organization
Organization Name:REACHING HANDS AS EACH ONE TEACHINGS ONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:YUMA
Authorized Official - Last Name:BRANNON
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN, CMIT, CCBT
Authorized Official - Phone:719-999-5054
Mailing Address - Street 1:4720 GALLEY RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80915-2735
Mailing Address - Country:US
Mailing Address - Phone:719-999-5054
Mailing Address - Fax:
Practice Address - Street 1:4720 GALLEY RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80915-2735
Practice Address - Country:US
Practice Address - Phone:719-999-5054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1942710546Medicaid
CO1942710546OtherBLUE CROSS BLUE SHIELD