Provider Demographics
NPI:1013738459
Name:ACHIEVE LIFE SOLUTIONS
Entity type:Organization
Organization Name:ACHIEVE LIFE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRIZER
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-227-7170
Mailing Address - Street 1:1549 LIVINGSTON AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:WEST SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-3420
Mailing Address - Country:US
Mailing Address - Phone:612-227-7170
Mailing Address - Fax:
Practice Address - Street 1:1549 LIVINGSTON AVE STE 108
Practice Address - Street 2:
Practice Address - City:WEST SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-3420
Practice Address - Country:US
Practice Address - Phone:612-227-7170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider Agency