Provider Demographics
NPI:1104060722
Name:REACHING NEW HEIGHTS
Entity type:Organization
Organization Name:REACHING NEW HEIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:EVETTE
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:EMPLOYMENT SPECIALIS
Authorized Official - Phone:336-918-4989
Mailing Address - Street 1:1001 S MARSHALL ST
Mailing Address - Street 2:BOX 118
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-5852
Mailing Address - Country:US
Mailing Address - Phone:336-918-4989
Mailing Address - Fax:
Practice Address - Street 1:1001 S MARSHALL ST
Practice Address - Street 2:SUITE 2-48
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-5852
Practice Address - Country:US
Practice Address - Phone:336-918-4989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health