Provider Demographics
NPI:1225603871
Name:DIVERSE ACHIEVERS LLC
Entity Type:Organization
Organization Name:DIVERSE ACHIEVERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:MR
Authorized Official - First Name:CHIBUZO
Authorized Official - Middle Name:POLYCARP
Authorized Official - Last Name:IWEAJUNWA
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:832-296-3123
Mailing Address - Street 1:20330 WHITEWOOD DR APT 5208
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-5562
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:29218 FOX FOUNTAIN LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-3096
Practice Address - Country:US
Practice Address - Phone:281-771-4910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities