Provider Demographics
NPI:1780931121
Name:ACHIEVE BEYOND
Entity type:Organization
Organization Name:ACHIEVE BEYOND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ABA THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHONONOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-529-2801
Mailing Address - Street 1:60 OCEANA DR W
Mailing Address - Street 2:PH1D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6662
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:60 OCEANA DR W
Practice Address - Street 2:PH1D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6662
Practice Address - Country:US
Practice Address - Phone:646-529-2801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency