Provider Demographics
NPI:1942075817
Name:ACHIEVABLE DREAM LLC
Entity Type:Organization
Organization Name:ACHIEVABLE DREAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:757-725-1914
Mailing Address - Street 1:16814 S MILES RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-3642
Mailing Address - Country:US
Mailing Address - Phone:757-725-1914
Mailing Address - Fax:
Practice Address - Street 1:16814 S MILES RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-3642
Practice Address - Country:US
Practice Address - Phone:757-725-1914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-20
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome HealthGroup - Single Specialty