Basic Information
| Provider Information | |||||||||
| NPI: | 1194098095 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACHIEVE BEYOND OF TEXAS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7000 AUSTIN ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | FOREST HILLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113751022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187627633 | ||||||||
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| Practice Location | |||||||||
| Address1: | 190 CIVIC CIR | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | LEWISVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750673424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722191200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2012 | ||||||||
| LastUpdateDate: | 04/17/2017 | ||||||||
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| AuthorizedOfficialLastName: | MATUZA | ||||||||
| AuthorizedOfficialFirstName: | JULIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 71876287633 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | N | 193200000X MULTI-SPECIALTY GROUP | 235Z00000X | N | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 225X00000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225100000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 251E00000X | N | Agencies | Home Health | 103K00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.