Basic Information
| Provider Information | |||||||||
| NPI: | 1952769531 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACHIEVE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2301 CROWNPOINT EXECUTIVE DR | ||||||||
| Address2: | SUITE E | ||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282277824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7047088314 | ||||||||
| FaxNumber: | 7047088315 | ||||||||
| Practice Location | |||||||||
| Address1: | 2301 CROWNPOINT EXECUTIVE DR | ||||||||
| Address2: | SUITE E | ||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282277824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7047088314 | ||||||||
| FaxNumber: | 7047088315 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2016 | ||||||||
| LastUpdateDate: | 02/10/2016 | ||||||||
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| AuthorizedOfficialLastName: | PIDGE | ||||||||
| AuthorizedOfficialFirstName: | SALLY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7047088314 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 0146077 | NC | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.