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General NPI Number Information
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NPI Number | 1982008272
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Entity Type | Organization
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Legal Business Name | PREPARINGPEOPLEFORSUCCESS
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Dates
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Enumeration Date | 10/15/2014
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Last Update Date | 10/15/2014
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Provider Practice Location Address
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Address Line | 1513 SPORTS DR SUITE 100
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City | SACRAMENTO
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State | CA
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Zip | 95834-1943
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Country | US
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Telephone | 916-575-8851
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Fax | 916-575-8861
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Provider Business Mailing Address
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Address Line | 8780 MADISON AVE 224
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City | FAIR OAKS
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State | CA
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Zip | 95628-3950
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Country | US
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Telephone | 530-903-0799
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Fax |
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Authorized Official
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Title or Position | EXECUTIVEDIRECTOR
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Name | MS. SHAWN WILLIAMS
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Credential | CADC-II
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Telephone | 916-575-8851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | GNB32012-03076
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License Number State | CA
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