1710091624 NPI number — REACH FOR RESOURCES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710091624 NPI number — REACH FOR RESOURCES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REACH FOR RESOURCES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710091624
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1001 HIGHWAY 7
Provider Second Line Business Mailing Address:
ROOM 217
Provider Business Mailing Address City Name:
HOPKINS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55305-4723
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
952-988-4177
Provider Business Mailing Address Fax Number:
952-988-6728

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 HIGHWAY 7
Provider Second Line Business Practice Location Address:
ROOM 217
Provider Business Practice Location Address City Name:
HOPKINS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55305-4723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-988-4177
Provider Business Practice Location Address Fax Number:
952-988-6728
Provider Enumeration Date:
08/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PERKINS
Authorized Official First Name:
MARY
Authorized Official Middle Name:
B
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
952-988-4177

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X , with the licence number:  1011289-1-WS , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251C00000X , with the licence number: 1011784-1-SILS , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 11G36WE . This is a "BLUE CROSS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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