Provider Demographics
NPI:1053466862
Name:ACHIEVEMENT ACADEMY, INC.
Entity type:Organization
Organization Name:ACHIEVEMENT ACADEMY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-683-6504
Mailing Address - Street 1:716 E BELLA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-3009
Mailing Address - Country:US
Mailing Address - Phone:863-683-6504
Mailing Address - Fax:863-688-9292
Practice Address - Street 1:716 E BELLA VISTA ST
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-3009
Practice Address - Country:US
Practice Address - Phone:863-683-6504
Practice Address - Fax:863-688-9292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL811515000Medicaid