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General NPI Number Information
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NPI Number | 1932683703
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Entity Type | Organization
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Legal Business Name | SUCCESS GROUPS INC
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 10/31/2018
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Provider Practice Location Address
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Address Line | 64 S 10TH ST
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City | SAN JOSE
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State | CA
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Zip | 95112-3501
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Country | US
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Telephone | 408-674-4406
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Fax | 408-490-4124
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Provider Business Mailing Address
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Address Line | PO BOX 22256
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City | SAN JOSE
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State | CA
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Zip | 95151-2256
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Country | US
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Telephone | 408-674-4406
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Fax | 408-490-4124
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | MR. PRINCE-STANLEY AMAS
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Credential |
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Telephone | 408-449-0357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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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 | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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