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General NPI Number Information
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NPI Number | 1619422284
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Entity Type | Organization
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Legal Business Name | SUCCESSFUL CONCEPTS INC.
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 08/23/2016
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Provider Practice Location Address
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Address Line | 5 COLD HILL RD S STE 18
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City | MENDHAM
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State | NJ
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Zip | 07945-3208
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Country | US
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Telephone | 862-284-7025
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Fax | 862-284-7164
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Provider Business Mailing Address
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Address Line | 25 ROC ETAM RD
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City | RANDOLPH
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State | NJ
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Zip | 07869-2427
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Country | US
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Telephone | 862-325-3459
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Fax | 862-284-7164
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MS. LIYA LIU
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Credential |
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Telephone | 862-325-3459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | HP0238200
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License Number State | NJ
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