Provider Demographics
NPI:1699196766
Name:REESE HEALTH SERVICES
Entity Type:Organization
Organization Name:REESE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSE
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:980-428-2473
Mailing Address - Street 1:1900 MCALLISTER DR APT C
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-0050
Mailing Address - Country:US
Mailing Address - Phone:704-392-3174
Mailing Address - Fax:
Practice Address - Street 1:1900 MCALLISTER DR APT C
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-0050
Practice Address - Country:US
Practice Address - Phone:704-392-3174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities