Provider Demographics
NPI:1164771747
Name:THE ACHIEVABLE FOUNDATION
Entity Type:Organization
Organization Name:THE ACHIEVABLE FOUNDATION
Other - Org Name:ACHIEVABLE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:IBARRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-266-7476
Mailing Address - Street 1:100 CORPORATE POINTE STE 270
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-8735
Mailing Address - Country:US
Mailing Address - Phone:424-266-7472
Mailing Address - Fax:310-596-8268
Practice Address - Street 1:5901 GREEN VALLEY CIR
Practice Address - Street 2:SUITE 405
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6938
Practice Address - Country:US
Practice Address - Phone:424-266-7474
Practice Address - Fax:310-596-8268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)