Basic Information
| Provider Information | |||||||||
| NPI: | 1174147797 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACHIEVE SIGNATURE REHABILITATION, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 TRINITY DR E STE 201 | ||||||||
| Address2: | |||||||||
| City: | DILLSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170198522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175028840 | ||||||||
| FaxNumber: | 7175028842 | ||||||||
| Practice Location | |||||||||
| Address1: | ONE KIRKLAND VILLAGE CIR | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106914500 | ||||||||
| FaxNumber: | 6106914541 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2020 | ||||||||
| LastUpdateDate: | 05/29/2020 | ||||||||
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| AuthorizedOfficialLastName: | BERNARDO | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT AND CEO | ||||||||
| AuthorizedOfficialTelephone: | 7175028840 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QH0700X | N | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech | 261QP2000X | N | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | 261Q00000X | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.