Healthcare Provider Details

I. General information

NPI: 1528299518
Provider Name (Legal Business Name): REACHING U CONSULTINGAGENCY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2009
Last Update Date: 11/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 N DAUGHTRY ST
ROCKY MOUNT NC
27801-5803
US

IV. Provider business mailing address

417 N DAUGHTRY ST
ROCKY MOUNT NC
27801-5803
US

V. Phone/Fax

Practice location:
  • Phone: 252-446-6873
  • Fax: 252-446-6873
Mailing address:
  • Phone: 252-446-6873
  • Fax: 252-442-6873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateNC
# 8
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number StateNC

VIII. Authorized Official

Name: MS. JACCQUELINE DAVIS
Title or Position: OFFICE MANAGER
Credential:
Phone: 252-446-6873