Healthcare Provider Details

I. General information

NPI: 1407933716
Provider Name (Legal Business Name): ACHIEVA RESOURCES CORPORATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MENDLESON DR
RICHMOND IN
47374-1230
US

IV. Provider business mailing address

PO BOX 1252
RICHMOND IN
47375-1252
US

V. Phone/Fax

Practice location:
  • Phone: 765-966-0502
  • Fax: 765-962-3179
Mailing address:
  • Phone: 765-966-0502
  • Fax: 765-962-3179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateIN

VIII. Authorized Official

Name: MISS LISA HUDDLESTON
Title or Position: CFO
Credential:
Phone: 765-966-0502