Provider Demographics
NPI:1023845492
Name:REIMAGINE REENTRY INC
Entity type:Organization
Organization Name:REIMAGINE REENTRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF DATA & EVALUATION
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DONNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:267-424-5562
Mailing Address - Street 1:1901 CENTRE AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-4378
Mailing Address - Country:US
Mailing Address - Phone:412-770-2162
Mailing Address - Fax:
Practice Address - Street 1:1901 CENTRE AVE STE 304
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-4378
Practice Address - Country:US
Practice Address - Phone:412-770-2162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty