Healthcare Provider Details

I. General information

NPI: 1750637781
Provider Name (Legal Business Name): ACHIEVEMENT CENTERS OF AMERICA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2012
Last Update Date: 07/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7723 TYLERS PLACE BLVD SUITE 297
WEST CHESTER OH
45069-4684
US

IV. Provider business mailing address

7723 TYLERS PLACE BLVD SUITE 297
WEST CHESTER OH
45069-4684
US

V. Phone/Fax

Practice location:
  • Phone: 513-448-0022
  • Fax:
Mailing address:
  • Phone: 513-448-0022
  • Fax:

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. GRANT HONNERT
Title or Position: CEO
Credential: M.ED.
Phone: 513-448-0022