Provider Demographics
NPI:1699183541
Name:SUCCESS IN MIND
Entity Type:Organization
Organization Name:SUCCESS IN MIND
Other - Org Name:CENTER FOR STUDENT SUCCESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIERE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-923-4174
Mailing Address - Street 1:318 BLACKWELL ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-2883
Mailing Address - Country:US
Mailing Address - Phone:919-923-4174
Mailing Address - Fax:919-937-9245
Practice Address - Street 1:318 BLACKWELL ST
Practice Address - Street 2:SUITE 130
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-2883
Practice Address - Country:US
Practice Address - Phone:919-923-4174
Practice Address - Fax:919-937-9245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center