Provider Demographics
NPI:1245037514
Name:REFORM AND REENTRY .ORGF
Entity type:Organization
Organization Name:REFORM AND REENTRY .ORGF
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NAOMIS
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:WARD
Authorized Official - Suffix:III
Authorized Official - Credentials:PSS
Authorized Official - Phone:623-284-9662
Mailing Address - Street 1:6802 N 67TH AVE APT 27204
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-9014
Mailing Address - Country:US
Mailing Address - Phone:623-284-9662
Mailing Address - Fax:
Practice Address - Street 1:6802 N 67TH AVE APT 27204
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-9014
Practice Address - Country:US
Practice Address - Phone:623-284-9662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-25
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty