Provider Demographics
NPI:1679846778
Name:THE REACH INSTITUTE OF NORTH WEST FLORIDA
Entity Type:Organization
Organization Name:THE REACH INSTITUTE OF NORTH WEST FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:RECTOR
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:850-622-2273
Mailing Address - Street 1:870 MACK BAYOU RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-7150
Mailing Address - Country:US
Mailing Address - Phone:850-622-2273
Mailing Address - Fax:
Practice Address - Street 1:870 MACK BAYOU RD
Practice Address - Street 2:SUITE D
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-7150
Practice Address - Country:US
Practice Address - Phone:850-622-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA39523225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty