Provider Demographics
NPI:1275858755
Name:SUCCESS HEALTHCARE
Entity Type:Organization
Organization Name:SUCCESS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANICA
Authorized Official - Middle Name:DEVI
Authorized Official - Last Name:VAUGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-328-0632
Mailing Address - Street 1:228 BRIDGEFIELD PL
Mailing Address - Street 2:APT C
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2996
Mailing Address - Country:US
Mailing Address - Phone:919-328-0632
Mailing Address - Fax:
Practice Address - Street 1:228 BRIDGEFIELD PLACE
Practice Address - Street 2:APT C
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705
Practice Address - Country:US
Practice Address - Phone:919-328-0632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010007633251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health