MEDICARE: REACHABA

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1083056139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REACHABA

Provider Business Mailing Address
First Line	:	333 W 41ST ST STE 414
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3608
Country	:	US
Telephone Number	:	786-673-9355
Fax Number	:	954-342-6481

Provider Business Practice Location Address
First Line	:	2650 W MONTROSE AVE STE 205
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-1674
Country	:	US
Telephone Number	:	773-609-4076
Fax Number	:	954-342-6481

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	REBECCA G RYAN
Credential	:
Telephone Number	:	561-892-6010

Provider Enumeration Date	:	07/17/2013
Last Update Date	:	01/12/2026

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