Healthcare Provider Details

I. General information

NPI: 1679477228
Provider Name (Legal Business Name): SUCCESS MANAGEMENT GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6014 W CONGRESS ST
MILWAUKEE WI
53218-5553
US

IV. Provider business mailing address

3819 N 9TH ST
MILWAUKEE WI
53206-3310
US

V. Phone/Fax

Practice location:
  • Phone: 414-239-0697
  • Fax:
Mailing address:
  • Phone: 414-239-0697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHARA MONIQUE HORTMAN
Title or Position: PRESIDENT
Credential:
Phone: 414-239-0697