MEDICARE: SUCCESSFUL LIVINGS LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility

General Provider Information

NPI Number	:	1194688135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUCCESSFUL LIVINGS LLC.

Provider Business Mailing Address
First Line	:	43646 W YUCCA LN
Second Line	:
City	:	MARICOPA
State	:	AZ
Zip	:	85138-2011
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	43646 W YUCCA LN
Second Line	:
City	:	MARICOPA
State	:	AZ
Zip	:	85138-2011
Country	:	US
Telephone Number	:	520-483-4219
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	DARRELL LEMONT ELLIS
Credential	:
Telephone Number	:	520-483-4219

Provider Enumeration Date	:	12/06/2025
Last Update Date	:	02/06/2026

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Directions to “SUCCESSFUL LIVINGS LLC. ” Practice Location

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