Provider Demographics
NPI:1851504856
Name:ACHIEVE TO SUCCEED ADHC
Entity Type:Organization
Organization Name:ACHIEVE TO SUCCEED ADHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MILDRED
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLAKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-357-5130
Mailing Address - Street 1:5675 LANCASTER STREET
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70805-1837
Mailing Address - Country:US
Mailing Address - Phone:225-357-5130
Mailing Address - Fax:
Practice Address - Street 1:5675 LANCASTER STREET
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805-1837
Practice Address - Country:US
Practice Address - Phone:225-357-5130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9947920001251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services