Provider Demographics
NPI:1174764195
Name:ACHIEVE REHABILITATION SERVICES LLC
Entity type:Organization
Organization Name:ACHIEVE REHABILITATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:609-625-5628
Mailing Address - Street 1:5690 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-3363
Mailing Address - Country:US
Mailing Address - Phone:609-625-5628
Mailing Address - Fax:609-625-1688
Practice Address - Street 1:5690 BIRCH ST
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-3363
Practice Address - Country:US
Practice Address - Phone:609-625-5628
Practice Address - Fax:609-625-1688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ078214Medicare PIN