Provider Demographics
NPI:1528665593
Name:ACHIEVE WHOLE RECOVERY, PC
Entity type:Organization
Organization Name:ACHIEVE WHOLE RECOVERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESEDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:719-632-4033
Mailing Address - Street 1:1115 ELKTON DR STE 300
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-3597
Mailing Address - Country:US
Mailing Address - Phone:719-373-9703
Mailing Address - Fax:
Practice Address - Street 1:129 KANSAS AVE
Practice Address - Street 2:
Practice Address - City:WALSENBURG
Practice Address - State:CO
Practice Address - Zip Code:81089-1818
Practice Address - Country:US
Practice Address - Phone:719-373-9703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty