Provider Demographics
NPI:1669689022
Name:SUCCESSFUL TRANSITIONS LLC
Entity Type:Organization
Organization Name:SUCCESSFUL TRANSITIONS LLC
Other - Org Name:SUCCESSFUL TRANSITIONS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:M ED
Authorized Official - Phone:336-312-3818
Mailing Address - Street 1:8300 CHARTWELL DR
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:27310-9814
Mailing Address - Country:US
Mailing Address - Phone:336-312-3818
Mailing Address - Fax:
Practice Address - Street 1:1458 LONDON DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27260-4263
Practice Address - Country:US
Practice Address - Phone:336-889-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL041818322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children