Provider Demographics
NPI:1073400347
Name:TEACH TO REACH LLC
Entity type:Organization
Organization Name:TEACH TO REACH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:561-531-1192
Mailing Address - Street 1:48 FOREST DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-1504
Mailing Address - Country:US
Mailing Address - Phone:561-531-1192
Mailing Address - Fax:
Practice Address - Street 1:1000 TOWN CTR
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-1183
Practice Address - Country:US
Practice Address - Phone:561-531-1192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10029535400Medicaid