Provider Demographics
NPI:1063569762
Name:REACH FOR YOUR POTENTIAL, INC
Entity type:Organization
Organization Name:REACH FOR YOUR POTENTIAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STACI
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMISTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-354-2983
Mailing Address - Street 1:1705 S 1ST AVE
Mailing Address - Street 2:SUITE I
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6006
Mailing Address - Country:US
Mailing Address - Phone:319-354-2983
Mailing Address - Fax:319-354-3221
Practice Address - Street 1:1705 S 1ST AVE
Practice Address - Street 2:SUITE I
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6006
Practice Address - Country:US
Practice Address - Phone:319-354-2983
Practice Address - Fax:319-354-3221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0100727Medicaid