MEDICARE: ACHIEVE BEHAVIOR HEALTH SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1760991897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACHIEVE BEHAVIOR HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	4557 HIDDEN STREAM CT
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-4837
Country	:	US
Telephone Number	:	804-931-8008
Fax Number	:

Provider Business Practice Location Address
First Line	:	4557 HIDDEN STREAM CT
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-4837
Country	:	US
Telephone Number	:	804-931-8008
Fax Number	:	800-413-0523

Authorized Official
Title or Position	:	CEO
Name	:	ANGELIQUE BROWN
Credential	:
Telephone Number	:	804-931-8008

Provider Enumeration Date	:	09/20/2017
Last Update Date	:	09/20/2017

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