Provider Demographics
NPI:1619120169
Name:ACHIEVING DREAMS CORPORATION
Entity Type:Organization
Organization Name:ACHIEVING DREAMS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TALLULAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-531-6766
Mailing Address - Street 1:15420 LIVINGSTON AVE
Mailing Address - Street 2:# 1201
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-3430
Mailing Address - Country:US
Mailing Address - Phone:813-531-6766
Mailing Address - Fax:813-531-6767
Practice Address - Street 1:15420 LIVINGSTON AVE
Practice Address - Street 2:# 1201
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-3430
Practice Address - Country:US
Practice Address - Phone:813-531-6766
Practice Address - Fax:813-531-6767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL691139198Medicaid
FL691139196Medicaid
FL230305OtherAHCA HOMEMAKER & COMPANION SERVICES