NPI Code Details Logo

NPI 1912358128

NPI 1912358128 : ACHIEVE WELLNESS, LLC : CHIPPEWA FALLS, WI

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1912358128
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    ACHIEVE WELLNESS, LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/29/2016
-----------------------------------------------------
    Last Update Date     |    03/11/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    703 LAKELAND DR STE 1 
-----------------------------------------------------
    City                 |    CHIPPEWA FALLS
-----------------------------------------------------
    State                |    WI
-----------------------------------------------------
    Zip                  |    54729-1629
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    715-832-9467
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    3300 BIRCH ST STE 1B 
-----------------------------------------------------
    City                 |    EAU CLAIRE
-----------------------------------------------------
    State                |    WI
-----------------------------------------------------
    Zip                  |    54703-2297
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    715-832-9467
-----------------------------------------------------
    Fax                  |    715-832-9574
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CEO
-----------------------------------------------------
    Name                 |    MRS. CATHERINE  GUILLIAMS-CHAN 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    715-832-9467
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QH0100X
-----------------------------------------------------
    Taxonomy Name        |    Health Service Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    261QP2300X
-----------------------------------------------------
    Taxonomy Name        |    Primary Care Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.