Organization
REACH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IVAN FORNEY (CO-OWNER)
(443) 815-1171
Entity
Organization
Contact information
Practice address
2214 JEFFERSON ST, BALTIMORE, MD 21205-2407
(443) 529-9083
Mailing address
1 N CHARLES ST STE 222, BALTIMORE, MD 21201-3710
(443) 831-1171
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220612732
BHA LICENSE NUMBER
MD
Enumeration date
12/19/2022
Last updated
02/27/2023
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