Resources for Education, Adaptation, Change, and Health, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

RESOURCES FOR EDUCATION, ADAPTATION, CHANGE, AND HEALTH, INC.

Doing business as

REACH of Louisville, Inc.

Practice address

501 Park Ave
Louisville, KY 40208-2318

Phone

(502) 585-1911

Fax

(501) 589-1582

NPI assigned

Dec 26, 2007

Last updated

May 20, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert John Illback, PSYD

Title

Ceo

Phone

(502) 585-1911

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• REACH of Louisville, Inc. Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Walter Sheppard Sanford, PSYD

  • Clinical Psychologist
  • Louisville, KY
  • NPI 1588191183
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432080000000",
    "number": "1730363862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 PARK AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402082318",
            "telephone_number": "502-585-1911",
            "fax_number": "501-589-1582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 PARK AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402082318",
            "telephone_number": "502-585-1911",
            "fax_number": "501-589-1582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESOURCES FOR EDUCATION, ADAPTATION, CHANGE, AND HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2015-05-20",
        "status": "A",
        "authorized_official_last_name": "ILLBACK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "502-585-1911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "KY",
            "license": "500165",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29101953",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33001108",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REACH of Louisville, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.