Provider Demographics
NPI:1336797190
Name:ACHIEVE REHABILITATION SERVICES AND SUPPORTS
Entity Type:Organization
Organization Name:ACHIEVE REHABILITATION SERVICES AND SUPPORTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HRICIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-977-8928
Mailing Address - Street 1:708 W WASHINGTON ST STE 1
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-6968
Mailing Address - Country:US
Mailing Address - Phone:724-977-8928
Mailing Address - Fax:
Practice Address - Street 1:708 W WASHINGTON ST STE 1
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-6968
Practice Address - Country:US
Practice Address - Phone:724-977-8928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health