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General NPI Number Information
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NPI Number | 1689840480
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Entity Type | Organization
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Legal Business Name | SUCCESSFUL SYSTEMS, INC.
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Dates
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Enumeration Date | 05/01/2008
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 699 CLAY ST
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City | WINTER PARK
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State | FL
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Zip | 32789-4553
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Country | US
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Telephone | 407-740-7673
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Fax | 407-875-0887
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Provider Business Mailing Address
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Address Line | 699 CLAY ST
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City | WINTER PARK
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State | FL
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Zip | 32789-4553
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Country | US
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Telephone | 407-740-7673
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Fax | 407-875-0887
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. MICHELE BETH RIVERS
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Credential | B.S., SLC, SE
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Telephone | 407-740-7673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | 229205
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License Number State | FL
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