Provider Demographics
NPI:1902044795
Name:REACHING YOUR GOALS, INC..
Entity Type:Organization
Organization Name:REACHING YOUR GOALS, INC..
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDNET
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBA
Authorized Official - Middle Name:R
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:919-832-6150
Mailing Address - Street 1:211 E SIX FORKS RD
Mailing Address - Street 2:STE 201
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7745
Mailing Address - Country:US
Mailing Address - Phone:919-832-6150
Mailing Address - Fax:919-832-6151
Practice Address - Street 1:1201 KENT RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-1977
Practice Address - Country:US
Practice Address - Phone:919-832-6150
Practice Address - Fax:919-832-6151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-092-721251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC830Medicaid