MEDICARE: R.E.A.C.H RESIDENTIAL & DAY TREATMENT FACILITY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	251C00000X	Developmentally Disabled Services Day Training Agency
3	251S00000X	Community/Behavioral Health Agency
4	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1568394997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R.E.A.C.H RESIDENTIAL & DAY TREATMENT FACILITY LLC

Provider Business Mailing Address
First Line	:	1337 WESTPHAL AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43227-2040
Country	:	US
Telephone Number	:	614-946-5504
Fax Number	:

Provider Business Practice Location Address
First Line	:	12340 NOLA LN APT 210
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28216-7024
Country	:	US
Telephone Number	:	614-946-5504
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	TOMIKA GORDON
Credential	:
Telephone Number	:	614-946-5504

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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