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General NPI Number Information
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NPI Number | 1083056139
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Entity Type | Organization
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Legal Business Name | REACHABA
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Dates
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Enumeration Date | 07/17/2013
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 2650 W MONTROSE AVE STE 205
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City | CHICAGO
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State | IL
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Zip | 60618-1674
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Country | US
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Telephone | 773-609-4076
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Fax | 954-342-6481
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Provider Business Mailing Address
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Address Line | 333 W 41ST ST STE 414
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3608
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Country | US
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Telephone | 786-673-9355
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Fax | 954-342-6481
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | REBECCA G RYAN
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Credential |
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Telephone | 561-892-6010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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