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General NPI Number Information
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NPI Number | 1821613506
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Entity Type | Organization
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Legal Business Name | ACHIEVE PSYCHIATRIC WELLNESS CENTER LLC
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Dates
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Enumeration Date | 06/09/2020
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Last Update Date | 06/18/2026
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Provider Practice Location Address
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Address Line | 1209 WEDGEWOOD RD
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City | ST JOHNS
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State | FL
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Zip | 32259-9012
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Country | US
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Telephone | 630-888-5985
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Fax |
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Provider Business Mailing Address
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Address Line | 450 STATE ROAD 13 N STE 106 493
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City | ST JOHNS
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State | FL
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Zip | 32259-3863
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Country | US
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Telephone | 904-517-8900
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Fax | 949-703-8088
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Authorized Official
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Title or Position | PMHNP-BC
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Name | DANA M HATWIG
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Credential | APRN PMHNP-BC
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Telephone | 904-517-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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