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General NPI Number Information
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NPI Number | 1477974970
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Entity Type | Organization
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Legal Business Name | ACHIEVE BEYOND EXPECTATIONS
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Dates
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Enumeration Date | 12/31/2013
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Last Update Date | 12/31/2013
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Provider Practice Location Address
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Address Line | 1425 PENNSYLVANIA AVE 8E
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City | BROOKLYN
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State | NY
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Zip | 11239-2108
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Country | US
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Telephone | 917-415-4473
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Fax | 718-942-0810
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Provider Business Mailing Address
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Address Line | 1425 PENNSYLVANIA AVE 8E
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City | BROOKLYN
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State | NY
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Zip | 11239-2108
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Country | US
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Telephone | 917-415-4473
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Fax | 718-942-0810
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. KIMBERLY JONELL JOHNSON
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Credential | TSHH
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Telephone | 917-415-4473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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