Provider Demographics
NPI:1235773516
Name:WITHIN ARMS REACH COMMUNITY SERVICES LLC
Entity Type:Organization
Organization Name:WITHIN ARMS REACH COMMUNITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-743-0243
Mailing Address - Street 1:2780 HOMESTEAD RD STE 203
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-5757
Mailing Address - Country:US
Mailing Address - Phone:512-743-0243
Mailing Address - Fax:702-921-0757
Practice Address - Street 1:2780 HOMESTEAD RD STE 205
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-5757
Practice Address - Country:US
Practice Address - Phone:702-640-0949
Practice Address - Fax:702-921-0757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1235773516Medicaid