Provider Demographics
NPI:1811402696
Name:SUCCESSFUL TREATMENTS, LLC
Entity Type:Organization
Organization Name:SUCCESSFUL TREATMENTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:949-237-0893
Mailing Address - Street 1:3530 E LA PALMA AVE APT 324
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-2158
Mailing Address - Country:US
Mailing Address - Phone:714-856-0620
Mailing Address - Fax:
Practice Address - Street 1:18 VIA ARMILLA
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-7204
Practice Address - Country:US
Practice Address - Phone:949-388-1953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health