Provider Demographics
NPI:1154869881
Name:ACHIEVEMENT BALANCE COMMUNITY LLC
Entity type:Organization
Organization Name:ACHIEVEMENT BALANCE COMMUNITY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-255-6964
Mailing Address - Street 1:830 PARKER SQ
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-7429
Mailing Address - Country:US
Mailing Address - Phone:940-255-6964
Mailing Address - Fax:844-685-8586
Practice Address - Street 1:830 PARKER SQ
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-7429
Practice Address - Country:US
Practice Address - Phone:940-255-6964
Practice Address - Fax:844-685-8586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1-11-8943103K00000X
TX1-13-14788103K00000X
TXTX-561291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty