Organization
REACH BACK FOR THE COMMUNITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASMINE O'NEIL HEFFNEY (CEO)
(980) 219-1589
Entity
Organization
Contact information
Practice address
3928 FAR WEST DR, CHARLOTTE, NC 28269-1720
(980) 219-1589
Mailing address
3928 FAR WEST DR, CHARLOTTE, NC 28269-1720
(980) 219-1589
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/27/2022
Last updated
06/25/2024
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