Provider Demographics
NPI:1326422213
Name:REACH FAMILY SERVICES
Entity Type:Organization
Organization Name:REACH FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:480-236-2552
Mailing Address - Street 1:3535 W SOUTHERN AVE
Mailing Address - Street 2:STE 128
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-4224
Mailing Address - Country:US
Mailing Address - Phone:602-512-9000
Mailing Address - Fax:
Practice Address - Street 1:3535 W SOUTHERN AVE
Practice Address - Street 2:STE 128
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-4224
Practice Address - Country:US
Practice Address - Phone:602-512-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZCSA15ADHS0225251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health