Basic Information
| Provider Information | |||||||||
| NPI: | 1841678554 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACHIEVE HEALTH AND WELLNESS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14819 ENERGY WAY | ||||||||
| Address2: | |||||||||
| City: | APPLE VALLEY | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551245757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9526831745 | ||||||||
| FaxNumber: | 9526831746 | ||||||||
| Practice Location | |||||||||
| Address1: | 14819 ENERGY WAY | ||||||||
| Address2: | |||||||||
| City: | APPLE VALLEY | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551245757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9526831745 | ||||||||
| FaxNumber: | 9526831746 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2015 | ||||||||
| LastUpdateDate: | 06/16/2018 | ||||||||
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| AuthorizedOfficialLastName: | HUBBARD | ||||||||
| AuthorizedOfficialFirstName: | BETHANY | ||||||||
| AuthorizedOfficialMiddleName: | MARIE | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9526831745 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT, DPT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | 9524 | MN | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.