Provider Demographics
NPI:1952037350
Name:REACHING STARS LLC
Entity Type:Organization
Organization Name:REACHING STARS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-799-0130
Mailing Address - Street 1:22150 ENOCH RD
Mailing Address - Street 2:
Mailing Address - City:CALHAN
Mailing Address - State:CO
Mailing Address - Zip Code:80808-8523
Mailing Address - Country:US
Mailing Address - Phone:719-799-0130
Mailing Address - Fax:
Practice Address - Street 1:22150 ENOCH RD
Practice Address - Street 2:
Practice Address - City:CALHAN
Practice Address - State:CO
Practice Address - Zip Code:80808-8523
Practice Address - Country:US
Practice Address - Phone:719-799-0130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty