Healthcare Provider Details

I. General information

NPI: 1194645200
Provider Name (Legal Business Name): SUCCESS BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2026
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32717 1ST AVE S STE 2
FEDERAL WAY WA
98003-5758
US

IV. Provider business mailing address

32717 1ST AVE S STE 2
FEDERAL WAY WA
98003-5758
US

V. Phone/Fax

Practice location:
  • Phone: 206-565-4018
  • Fax:
Mailing address:
  • Phone: 206-565-4018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NAGAHE BOUH
Title or Position: OWNER
Credential:
Phone: 206-565-4018