MEDICARE: REACHING HIGHER BEHAVIORAL HEALTH 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1942703061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REACHING HIGHER BEHAVIORAL HEALTH LLC

Provider Business Mailing Address
First Line	:	2805 WHITE STREET
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89303
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2805 WHITE STREET
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89303-8903
Country	:	US
Telephone Number	:	702-351-2624
Fax Number	:

Authorized Official
Title or Position	:	MANANGER
Name	:	ANDREA BARKSDALE
Credential	:
Telephone Number	:	702-351-2624

Provider Enumeration Date	:	03/15/2018
Last Update Date	:	03/15/2018

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