Provider Demographics
NPI:1821613506
Name:ACHIEVE PSYCHIATRIC WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:ACHIEVE PSYCHIATRIC WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HATWIG
Authorized Official - Suffix:
Authorized Official - Credentials:APRN PMHNP-BC
Authorized Official - Phone:904-517-8900
Mailing Address - Street 1:450 STATE ROAD 13 NORTH
Mailing Address - Street 2:SUITE 106 PMB 493
Mailing Address - City:ST JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259
Mailing Address - Country:US
Mailing Address - Phone:904-517-8900
Mailing Address - Fax:239-963-8354
Practice Address - Street 1:1209 WEDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:ST JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-9012
Practice Address - Country:US
Practice Address - Phone:630-888-5985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Single Specialty