Provider Demographics
NPI:1477974970
Name:ACHIEVE BEYOND EXPECTATIONS
Entity Type:Organization
Organization Name:ACHIEVE BEYOND EXPECTATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:JONELL
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:TSHH
Authorized Official - Phone:917-415-4473
Mailing Address - Street 1:1425 PENNSYLVANIA AVE
Mailing Address - Street 2:8E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11239-2108
Mailing Address - Country:US
Mailing Address - Phone:917-415-4473
Mailing Address - Fax:718-942-0810
Practice Address - Street 1:1425 PENNSYLVANIA AVE
Practice Address - Street 2:8E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11239-2108
Practice Address - Country:US
Practice Address - Phone:917-415-4473
Practice Address - Fax:718-942-0810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-31
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty