Provider Demographics
NPI:1275090458
Name:REACT BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:REACT BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:REVOLORIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-251-5842
Mailing Address - Street 1:20 CIRCUIT RD
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:ME
Mailing Address - Zip Code:03901-2872
Mailing Address - Country:US
Mailing Address - Phone:207-251-5842
Mailing Address - Fax:
Practice Address - Street 1:5 BRAGDON LN STE 3
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-7262
Practice Address - Country:US
Practice Address - Phone:207-251-5842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health