Provider Demographics
NPI:1487838538
Name:REACHING INDEPENDENCE & SELF EMPOWERMENT
Entity Type:Organization
Organization Name:REACHING INDEPENDENCE & SELF EMPOWERMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:AS
Authorized Official - Phone:252-217-3844
Mailing Address - Street 1:316 US HIGHWAY 64 W
Mailing Address - Street 2:
Mailing Address - City:CRESWELL
Mailing Address - State:NC
Mailing Address - Zip Code:27928-9020
Mailing Address - Country:US
Mailing Address - Phone:252-797-4020
Mailing Address - Fax:
Practice Address - Street 1:316 US HIGHWAY 64 W
Practice Address - Street 2:
Practice Address - City:CRESWELL
Practice Address - State:NC
Practice Address - Zip Code:27928-9020
Practice Address - Country:US
Practice Address - Phone:252-797-4020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services