Provider Demographics
NPI:1114780848
Name:ACHIEVE ABA THERAPY LLC
Entity Type:Organization
Organization Name:ACHIEVE ABA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-859-4087
Mailing Address - Street 1:510 W RODEO RD
Mailing Address - Street 2:
Mailing Address - City:SNOWFLAKE
Mailing Address - State:AZ
Mailing Address - Zip Code:85937-0709
Mailing Address - Country:US
Mailing Address - Phone:801-859-4087
Mailing Address - Fax:
Practice Address - Street 1:100 W SPLIT ROCK FALLS DR
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:AZ
Practice Address - Zip Code:85939-2712
Practice Address - Country:US
Practice Address - Phone:801-859-4087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No252Y00000XAgenciesEarly Intervention Provider Agency