Provider Demographics
NPI:1891918769
Name:SUCCESS ENTERPRISES INC
Entity Type:Organization
Organization Name:SUCCESS ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOLSTENHULME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-745-7831
Mailing Address - Street 1:290 W 1ST S
Mailing Address - Street 2:
Mailing Address - City:RIGBY
Mailing Address - State:ID
Mailing Address - Zip Code:83442-1318
Mailing Address - Country:US
Mailing Address - Phone:208-745-7831
Mailing Address - Fax:208-745-0658
Practice Address - Street 1:290 W 1ST S
Practice Address - Street 2:
Practice Address - City:RIGBY
Practice Address - State:ID
Practice Address - Zip Code:83442-1318
Practice Address - Country:US
Practice Address - Phone:208-745-7831
Practice Address - Fax:208-745-0658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health