Provider Demographics
NPI:1437409323
Name:VALLEY ACHIEVEMENT CENTER
Entity Type:Organization
Organization Name:VALLEY ACHIEVEMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD IN PSYCHOLOGY
Authorized Official - Phone:661-617-6040
Mailing Address - Street 1:1721 WESTWIND DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3026
Mailing Address - Country:US
Mailing Address - Phone:661-431-1466
Mailing Address - Fax:661-431-1479
Practice Address - Street 1:1721 WESTWIND DR
Practice Address - Street 2:STE 100
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3026
Practice Address - Country:US
Practice Address - Phone:661-431-1466
Practice Address - Fax:661-431-1479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15-63362-6200216171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty