Healthcare Provider Details

I. General information

NPI: 1083978811
Provider Name (Legal Business Name): ACHIEVEMENTS UNLIMITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2012
Last Update Date: 01/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9510 PAGE AVE
SAINT LOUIS MO
63132-1524
US

IV. Provider business mailing address

9510 PAGE AVE
SAINT LOUIS MO
63132-1524
US

V. Phone/Fax

Practice location:
  • Phone: 314-322-3027
  • Fax: 314-773-0091
Mailing address:
  • Phone: 314-322-3027
  • Fax: 314-773-0091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MELISSA WEBER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 314-322-3027