Provider Demographics
NPI:1235912924
Name:MY ACHIEVEMENT CENTER
Entity Type:Organization
Organization Name:MY ACHIEVEMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIAL/CONTRACTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:567-377-6316
Mailing Address - Street 1:3950 AIRPORT HWY APT 113
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-7156
Mailing Address - Country:US
Mailing Address - Phone:567-377-6316
Mailing Address - Fax:
Practice Address - Street 1:3950 AIRPORT HWY APT 113
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-7156
Practice Address - Country:US
Practice Address - Phone:567-377-6316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MY ACHIEVEMENT CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-16
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health