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General NPI Number Information
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NPI Number | 1467936161
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Entity Type | Organization
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Legal Business Name | SUCCESS CARE SERVICES, LLC
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 1500 MAXIMILIAN DR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-6555
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Country | US
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Telephone | 813-850-4970
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Fax | 813-991-5071
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Provider Business Mailing Address
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Address Line | 23975 CAMPANIA PASS
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City | LAND O LAKES
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State | FL
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Zip | 34639-5475
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Country | US
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Telephone | 813-850-4970
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Fax | 813-991-5071
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | OLUMUYIWA SUNDAY ADEDOYIN
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Credential |
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Telephone | 813-850-4970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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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 | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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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 | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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