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General NPI Number Information
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NPI Number | 1861218208
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Entity Type | Organization
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Legal Business Name | SUCCEED COUNSELING AND TRANSITIONAL PROGRAM LLC
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 310 MID CONTINENT PLZ STE 320
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-1749
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Country | US
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Telephone | 501-442-1232
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Fax |
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Provider Business Mailing Address
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Address Line | 179 N GEORGE CIR
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City | MARION
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State | AR
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Zip | 72364-8007
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Country | US
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Telephone | 501-442-1232
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LATISSHA LENDORA LEFLORE
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Credential | LADAC CADC
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Telephone | 501-442-1232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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