MEDICARE: SUCCESSFUL SOLUTIONS,MHS,INC.

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		NC

General Provider Information

NPI Number	:	1356674212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUCCESSFUL SOLUTIONS,MHS,INC.

Provider Business Mailing Address
First Line	:	3622 SHANNON RD STE 103
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-3771
Country	:	US
Telephone Number	:	919-259-2017
Fax Number	:

Provider Business Practice Location Address
First Line	:	3622 SHANNON RD STE 103
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-3771
Country	:	US
Telephone Number	:	919-259-2017
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PATRICIA WATKINS
Credential	:
Telephone Number	:	919-259-2017

Provider Enumeration Date	:	09/10/2009
Last Update Date	:	09/10/2009

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