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General NPI Number Information
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NPI Number | 1093986820
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Entity Type | Organization
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Legal Business Name | BE A SUCCESS ENTERPRISES LLC
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 14210 SE 85TH AVE
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City | SUMMERFIELD
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State | FL
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Zip | 34491-9380
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Country | US
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Telephone | 352-347-3577
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Fax |
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Provider Business Mailing Address
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Address Line | 14210 SE 85TH AVE
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City | SUMMERFIELD
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State | FL
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Zip | 34491-9380
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND CEO
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Name | BARBARA ELGIN
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Credential | MSW, LCSW
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Telephone | 352-347-3577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | SW 8873
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License Number State | FL
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