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General NPI Number Information
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NPI Number | 1730888934
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Entity Type | Organization
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Legal Business Name | ACHIEVE PEDIATRIC THERAPY GA LLC
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 10/13/2023
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Provider Practice Location Address
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Address Line | 260 PEACHTREE ST NW STE 2200
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City | ATLANTA
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State | GA
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Zip | 30303-1292
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Country | US
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Telephone | 847-868-6531
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Fax |
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Provider Business Mailing Address
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Address Line | 6137 N BERNARD ST
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City | CHICAGO
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State | IL
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Zip | 60659-2211
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Country | US
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Telephone | 847-868-6531
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. BASYA GOLDFEDER
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Credential |
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Telephone | 847-868-6531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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