Provider Demographics
NPI:1952411175
Name:FAMILY ACHIEVEMENT CENTER INC.
Entity Type:Organization
Organization Name:FAMILY ACHIEVEMENT CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-738-9880
Mailing Address - Street 1:2101 WOODDALE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-4441
Mailing Address - Country:US
Mailing Address - Phone:651-738-9888
Mailing Address - Fax:651-738-9889
Practice Address - Street 1:2101 WOODDALE DR
Practice Address - Street 2:SUITE A
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-4441
Practice Address - Country:US
Practice Address - Phone:651-738-9888
Practice Address - Fax:651-738-9889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN47G29FAOtherBCBS - OT
MN48G18FAOtherBCBS - ST
MN1030327OtherPREFERRED ONE
MN930379100Medicaid
MN47G26FAOtherBCBS - PT
MN47G29FAOtherBCBS - OT