MEDICARE: REACHING YOUR GOALS

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1861636698
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REACHING YOUR GOALS

Provider Business Mailing Address
First Line	:	1203 KENT RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27606-1977
Country	:	US
Telephone Number	:	919-896-7602
Fax Number	:	919-896-7605

Provider Business Practice Location Address
First Line	:	1203 KENT RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27606-1977
Country	:	US
Telephone Number	:	919-896-7602
Fax Number	:	919-896-7605

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. REBA R WILLIAMS
Credential	:	MS
Telephone Number	:	919-896-7602

Provider Enumeration Date	:	04/23/2009
Last Update Date	:	04/23/2009

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Directions to “REACHING YOUR GOALS ” Practice Location

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