| Name: | Achievement Pediatric Therapies, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 19 Feb 2019 (6 years ago) |
| Entity Number: | 000-544-468 |
| Register Number: | 000544468 |
| County: | Blount |
| Place of Formation: | Blount County |
| Registered Office Street Address: | 205 NESMITH ROADBLOUNTSVILLE, AL 35031 |
| Registered Office Street Address ZIP Code: | 35031 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174088959 | 2019-02-05 | 2019-02-05 | 205 NESMITH RD, BLOUNTSVILLE, AL, 350316717, US | 530 SPARKMAN ST SW, HARTSELLE, AL, 356403120, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 256-585-5925 |
Authorized person
| Name | MRS. LAUREN MICHELLE LONG |
| Role | OWNER/COTA |
| Phone | 2565855925 |
Taxonomy
| Taxonomy Code | 224Z00000X - Occupational Therapy Assistant |
| Is Primary | Yes |
| Taxonomy Code | 2251P0200X - Pediatric Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 225200000X - Physical Therapy Assistant |
| Is Primary | No |
| Taxonomy Code | 225XP0200X - Pediatric Occupational Therapist |
| Is Primary | No |
| Taxonomy Code | 2355S0801X - Speech-Language Assistant |
| Is Primary | No |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 3873 |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ACHIEVEMENT PEDIATRIC THERAPIES 401(K) PLAN | 2023 | 833446723 | 2024-07-22 | ACHIEVEMENT PEDIATRIC THERAPIES, LLC | 12 | |||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-22 |
| Name of individual signing | CHRIS HORNE |
| Name | Role | Address |
|---|---|---|
| LONG, LAUREN | Agent | 205 KNOLLRIDGE CIRCLEHUNTSVILLE, AL 35801 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
