Provider Demographics
NPI:1619422284
Name:SUCCESSFUL CONCEPTS INC.
Entity Type:Organization
Organization Name:SUCCESSFUL CONCEPTS INC.
Other - Org Name:FIRSTLIGHT HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-325-3459
Mailing Address - Street 1:25 ROC ETAM RD
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2427
Mailing Address - Country:US
Mailing Address - Phone:862-325-3459
Mailing Address - Fax:862-284-7164
Practice Address - Street 1:5 COLD HILL RD S STE 18
Practice Address - Street 2:
Practice Address - City:MENDHAM
Practice Address - State:NJ
Practice Address - Zip Code:07945-3208
Practice Address - Country:US
Practice Address - Phone:862-284-7025
Practice Address - Fax:862-284-7164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0238200253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care