Provider Demographics
NPI:1952689044
Name:ACHIEVE THERAPY SERVICES
Entity Type:Organization
Organization Name:ACHIEVE THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:K
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:321-543-2771
Mailing Address - Street 1:137 MARTESIA WAY
Mailing Address - Street 2:
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3571
Mailing Address - Country:US
Mailing Address - Phone:321-543-2771
Mailing Address - Fax:321-773-4298
Practice Address - Street 1:137 MARTESIA WAY
Practice Address - Street 2:
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3571
Practice Address - Country:US
Practice Address - Phone:321-543-2771
Practice Address - Fax:321-773-4298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19409225100000X
FLOT3556225X00000X
FLSA7311235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL882042200Medicaid
FL892036200Medicaid
FL882042200Medicaid
FL892036200Medicaid