Provider Demographics
NPI:1700334307
Name:WITHIN REACH LLC
Entity Type:Organization
Organization Name:WITHIN REACH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:KENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BSN, RN
Authorized Official - Phone:207-536-4860
Mailing Address - Street 1:169 OCEAN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-3636
Mailing Address - Country:US
Mailing Address - Phone:207-536-4860
Mailing Address - Fax:207-536-4861
Practice Address - Street 1:169 OCEAN ST STE 201
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-3636
Practice Address - Country:US
Practice Address - Phone:207-536-4860
Practice Address - Fax:207-536-4861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health