Organization
AXIOM LINK, INC.
Active
Parent organization
ACHIEVE BEYOND
Other names
Achieve Beyond
Organization subpart
Yes
Provider details
NPI number
Legal business name
ACHIEVE BEYOND
Authorized official
JULIA SUE MATUZA (CEO)
(718) 762-7633
Entity
Organization
Contact information
Practice address
11240 WAPLES MILL RD, SUITE 101, FAIRFAX, VA 22030-6078
(703) 237-2219
(703) 237-2729
Mailing address
7000 AUSTIN ST, SUITE 200, FOREST HILLS, NY 11375-1022
(718) 762-7633
(718) 886-8694
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225720
MEDICARE PTAN
—
Enumeration date
12/09/2009
Last updated
04/17/2017
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