Provider Demographics
NPI:1043557341
Name:S.U.C.C.E.S.SERVICES
Entity Type:Organization
Organization Name:S.U.C.C.E.S.SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SERVICES
Authorized Official - Prefix:MISS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:WORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-401-0145
Mailing Address - Street 1:1764 STATE ROUTE 339
Mailing Address - Street 2:
Mailing Address - City:BELPRE
Mailing Address - State:OH
Mailing Address - Zip Code:45714-8035
Mailing Address - Country:US
Mailing Address - Phone:740-401-0145
Mailing Address - Fax:740-401-0145
Practice Address - Street 1:1764 STATE ROUTE 339
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-8035
Practice Address - Country:US
Practice Address - Phone:740-401-0145
Practice Address - Fax:740-401-0145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities