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NPI Code Detail

MEDICARE: SUCCESS CARE LLC

MEDICARE: SUCCESS CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1033847330
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUCCESS CARE LLC
Provider Business Mailing Address
First Line : 1346 BUTLER AVE SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49507-1984
Country : US
Telephone Number : 616-368-8157
Fax Number :
Provider Business Practice Location Address
First Line : 1346 BUTLER AVE SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49507-1984
Country : US
Telephone Number : 616-368-8157
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. ANTON CAWLEY
Credential :
Telephone Number : 616-368-8157
Provider Enumeration Date : 08/13/2022
Last Update Date : 08/13/2022

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Directions to “SUCCESS CARE LLC ” Practice Location

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