Achieve Therapy LLC
Organization Active NPI Physical Therapist · Park River, ND
NPI 1063850436 · NPPES record last updated Feb 25, 2021
Key facts
- NPI
- 1063850436
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- ACHIEVE THERAPY LLC
- Practice address
- 403 Briggs Ave S
Park River, ND 58270-4023 - Phone
- (701) 284-6707
- NPI assigned
- Jun 7, 2013
- Organization subpart
- No
Authorized official
- Name
- Michelle D Ellis
- Title
- Business Manager
- Phone
- (701) 746-8374
Other NPIs on the same Medicare enrollment 2
Corporate family (same tax ID) 1
Practitioners 5
-
Mary Lynn Berntson, OTRL CHT
-
Nicole J Chine, PT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040225000374 | ND | Part B Supplier - Clinic/Group Practice | 6608762836 |
Receives reassigned benefits from 12 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Grand Forks, ND; Minot, ND; Park River, ND |
National Provider Directory
- Tax ID family
- Achieve Therapy
Locations
2424 32nd Ave S
Ste 103
Grand Forks, ND 58201
Phone (701) 792-6700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
Addresses
Primary practice location
403 Briggs Ave S
Park River, ND 58270-4023
Mailing address
1425 S Columbia Rd
Grand Forks, ND 58201-4039
Phone (701) 746-8374
Other providers in Park River, ND
All providers in Park River, ND · Physical Therapist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.