Healthcare Provider Details

I. General information

NPI: 1639736838
Provider Name (Legal Business Name): ACHIEVE WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 05/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 MERRIMACK ST STE 712
HAVERHILL MA
01830-6145
US

IV. Provider business mailing address

26 PILLSBURY RD
E HAMPSTEAD NH
03826-2502
US

V. Phone/Fax

Practice location:
  • Phone: 978-891-4928
  • Fax: 978-945-4787
Mailing address:
  • Phone: 978-891-4928
  • Fax: 978-945-4787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: REBECCA HARDING-FAUTH
Title or Position: MANAGER
Credential: PMHNP
Phone: 978-891-4928