Provider Demographics
NPI:1538758586
Name:ACHIEVE MENTAL WELLNESS
Entity type:Organization
Organization Name:ACHIEVE MENTAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:L
Authorized Official - Last Name:APPLEGATE-ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-244-3675
Mailing Address - Street 1:2666 S 2000 E STE 101
Mailing Address - Street 2:
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84109-1721
Mailing Address - Country:US
Mailing Address - Phone:801-244-3675
Mailing Address - Fax:801-855-7998
Practice Address - Street 1:2666 S 2000 E STE 101
Practice Address - Street 2:
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84109-1721
Practice Address - Country:US
Practice Address - Phone:801-244-3675
Practice Address - Fax:801-855-7998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty