MEDICARE: REACH HIGHER ABA UTAH, LLC

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	:	1740150051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REACH HIGHER ABA UTAH, LLC

Provider Business Mailing Address
First Line	:	700 ROCKAWAY TPKE STE 202
Second Line	:
City	:	LAWRENCE
State	:	NY
Zip	:	11559-1014
Country	:	US
Telephone Number	:	917-423-6997
Fax Number	:	917-423-6997

Provider Business Practice Location Address
First Line	:	2150 S 1300 E STE 520-07
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-4333
Country	:	US
Telephone Number	:	917-423-6997
Fax Number	:	917-423-6997

Authorized Official
Title or Position	:	CEO
Name	:	YOSEF GALEN
Credential	:
Telephone Number	:	917-423-6997

Provider Enumeration Date	:	11/11/2025
Last Update Date	:	11/11/2025

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