| Organization Name: | NORTHREACH HEALTHCARE, LLC |
| NPI Number: | 1710039318 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CAROL HIPKE (DIRECTOR OF BUSINESS SERVICES) |
| Mailing Address: | 441 French St Peshtigo |
| State: | WI US |
| Postal Code: | 541571203 |
| Phone Number: | 7155829949 |
| Fax Number: | 7155824464 |
| NPI Enumeration Date: | 01/17/2007 |
| NPI Last Update Date: | 09/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |