Provider Demographics
NPI:1306483508
Name:ACHIEVE WELLNESS CLINIC
Entity type:Organization
Organization Name:ACHIEVE WELLNESS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILLIAMS-CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-832-9467
Mailing Address - Street 1:3300 BIRCH ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703-2297
Mailing Address - Country:US
Mailing Address - Phone:715-832-9467
Mailing Address - Fax:715-832-9574
Practice Address - Street 1:1417 WINCHESTER WAY
Practice Address - Street 2:SUITE 6
Practice Address - City:ALTOONA
Practice Address - State:WI
Practice Address - Zip Code:54720-5472
Practice Address - Country:US
Practice Address - Phone:715-514-4734
Practice Address - Fax:715-832-9574
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACHIEVE WELLNESS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-06
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care