Provider Demographics
NPI:1700481561
Name:ASD FOR SUCCESS CORP
Entity type:Organization
Organization Name:ASD FOR SUCCESS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:MARGARITA
Authorized Official - Last Name:DE LA TORRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-450-3069
Mailing Address - Street 1:1331 ALANA DR APT 101
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7033
Mailing Address - Country:US
Mailing Address - Phone:407-450-3069
Mailing Address - Fax:
Practice Address - Street 1:1331 ALANA DR APT 101
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7033
Practice Address - Country:US
Practice Address - Phone:407-450-3069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health