Provider Demographics
NPI:1821695263
Name:SUCCESS UNLIMITED INC
Entity Type:Organization
Organization Name:SUCCESS UNLIMITED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHODA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-775-3356
Mailing Address - Street 1:2850 24TH AVE S STE 302
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-5831
Mailing Address - Country:US
Mailing Address - Phone:218-779-2998
Mailing Address - Fax:701-330-0736
Practice Address - Street 1:2850 24TH AVE S STE 302
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-5831
Practice Address - Country:US
Practice Address - Phone:218-779-2998
Practice Address - Fax:701-330-0736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1456246Medicaid