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General NPI Number Information
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NPI Number | 1235351446
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Entity Type | Organization
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Legal Business Name | SUCCESS FAMILY SERVICES, INC.
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 09/03/2007
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Provider Practice Location Address
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Address Line | 7537 BRIGHTON HILL LN
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City | RALEIGH
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State | NC
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Zip | 27616-8306
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Country | US
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Telephone | 919-217-7044
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Fax |
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Provider Business Mailing Address
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Address Line | 7537 BRIGHTON HILL LN
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City | RALEIGH
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State | NC
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Zip | 27616-8306
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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 | CLINICAL DIRECTOR
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Name | SHUKAIRO MACK TOWNSEND
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Credential | QP
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Telephone | 919-217-7044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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