Provider Demographics
NPI:1639395718
Name:ACHIEVE CENTER, INC.
Entity Type:Organization
Organization Name:ACHIEVE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WESLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:715-845-4900
Mailing Address - Street 1:2600 STEWART AVE STE 38
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-1404
Mailing Address - Country:US
Mailing Address - Phone:715-845-4900
Mailing Address - Fax:715-845-4970
Practice Address - Street 1:2600 STEWART AVE STE 38
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-1404
Practice Address - Country:US
Practice Address - Phone:715-845-4900
Practice Address - Fax:715-845-4970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2719261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)