MEDICARE: REACHING HIGHER, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	000427	NY
2	103K00000X	Behavior Analyst	000427	NY

General Provider Information

NPI Number	:	1376993527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REACHING HIGHER, INC

Provider Business Mailing Address
First Line	:	204 CLERMONT PL
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-5102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1068 40TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-1029
Country	:	US
Telephone Number	:	718-673-6446
Fax Number	:	718-673-6446

Authorized Official
Title or Position	:	DIRECTOR
Name	:	YITZCHOK KRAKAUER
Credential	:	BCBA, LBA
Telephone Number	:	718-673-6446

Provider Enumeration Date	:	06/20/2016
Last Update Date	:	05/09/2017

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