Provider Demographics
NPI:1932683703
Name:SUCCESS GROUPS INC
Entity Type:Organization
Organization Name:SUCCESS GROUPS INC
Other - Org Name:SUCCESS RCF1
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PRINCE-STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:AMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-449-0357
Mailing Address - Street 1:PO BOX 22256
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95151-2256
Mailing Address - Country:US
Mailing Address - Phone:408-674-4406
Mailing Address - Fax:408-490-4124
Practice Address - Street 1:64 S 10TH ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-3501
Practice Address - Country:US
Practice Address - Phone:408-674-4406
Practice Address - Fax:408-490-4124
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUCCESS GROUPS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-18
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities