Healthcare Provider Details

I. General information

NPI: 1861636698
Provider Name (Legal Business Name): REACHING YOUR GOALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2009
Last Update Date: 04/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 KENT RD
RALEIGH NC
27606-1977
US

IV. Provider business mailing address

1203 KENT RD
RALEIGH NC
27606-1977
US

V. Phone/Fax

Practice location:
  • Phone: 919-896-7602
  • Fax: 919-896-7605
Mailing address:
  • Phone: 919-896-7602
  • Fax: 919-896-7605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. REBA R WILLIAMS
Title or Position: PRESIDENT
Credential: MS
Phone: 919-896-7602