Healthcare Provider Details

I. General information

NPI: 1053993758
Provider Name (Legal Business Name): ACHIEVE BETTER HEALTH COOPERATIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2275 AUTUMN FIRE CT
LAS VEGAS NV
89117-8956
US

IV. Provider business mailing address

2275 AUTUMN FIRE CT
LAS VEGAS NV
89117-8956
US

V. Phone/Fax

Practice location:
  • Phone: 725-735-4145
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JENALI BRICHER
Title or Position: COOPERATIVE ADMINISTRATOR
Credential:
Phone: 614-886-1219