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General NPI Number Information
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NPI Number | 1912829987
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Entity Type | Organization
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Legal Business Name | SUCCESSWORKS 264 LLC
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Dates
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Enumeration Date | 07/29/2026
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Last Update Date | 07/29/2026
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Provider Practice Location Address
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Address Line | 107 SADDLEHORSE LN
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City | GREENSBORO
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State | NC
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Zip | 27405-9804
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Country | US
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Telephone | 336-332-9600
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Fax |
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Provider Business Mailing Address
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Address Line | 107 SADDLEHORSE LN
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City | GREENSBORO
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State | NC
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Zip | 27405-9804
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Country | US
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Telephone | 336-332-9600
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. SALENA EBOKPO
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Credential | LLC
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Telephone | 336-332-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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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 | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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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 | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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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 | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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