Provider Demographics
NPI:1376759902
Name:SUCCESS REHABILITATION, INC.
Entity Type:Organization
Organization Name:SUCCESS REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:RAUB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-538-3488
Mailing Address - Street 1:5666 CLYMER RD
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-3264
Mailing Address - Country:US
Mailing Address - Phone:215-538-3488
Mailing Address - Fax:215-538-8931
Practice Address - Street 1:5666 CLYMER ROAD
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-3264
Practice Address - Country:US
Practice Address - Phone:215-538-3488
Practice Address - Fax:215-538-8931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAA98000320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1006808940006Medicaid
PA1006808940002Medicaid