Provider Demographics
NPI:1104639905
Name:ACHIEVE GA LLC
Entity type:Organization
Organization Name:ACHIEVE GA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:MALKA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUSSBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:732-886-8113
Mailing Address - Street 1:126 MELVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4235
Mailing Address - Country:US
Mailing Address - Phone:732-886-8113
Mailing Address - Fax:
Practice Address - Street 1:1201 W PEACHTREE ST NW STE 2003
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3453
Practice Address - Country:US
Practice Address - Phone:732-886-8113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty