Provider Demographics
NPI:1467916098
Name:REACA PEARL LLC
Entity Type:Organization
Organization Name:REACA PEARL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REACA
Authorized Official - Middle Name:N
Authorized Official - Last Name:PEARL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:303-260-9540
Mailing Address - Street 1:607 10TH ST STE 303
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-5829
Mailing Address - Country:US
Mailing Address - Phone:303-260-9540
Mailing Address - Fax:
Practice Address - Street 1:607 10TH ST STE 303
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5829
Practice Address - Country:US
Practice Address - Phone:303-260-9540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-28
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty