Provider Demographics
NPI:1760343156
Name:HALO REENTRY INC.
Entity type:Organization
Organization Name:HALO REENTRY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:JON
Authorized Official - Last Name:PAVLIK
Authorized Official - Suffix:
Authorized Official - Credentials:QBHA/PRC
Authorized Official - Phone:719-644-4387
Mailing Address - Street 1:801 S TEJON ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-4148
Mailing Address - Country:US
Mailing Address - Phone:719-644-4387
Mailing Address - Fax:
Practice Address - Street 1:801 S TEJON ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-4148
Practice Address - Country:US
Practice Address - Phone:719-644-4387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty