Provider Demographics
NPI:1952530834
Name:SUCESSFUL ACHIEVEMENTS PROGRAM INCORPORATED
Entity Type:Organization
Organization Name:SUCESSFUL ACHIEVEMENTS PROGRAM INCORPORATED
Other - Org Name:ALMEDA WORTHAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWEN/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALMEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WORTHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-456-5200
Mailing Address - Street 1:133 US 1 A
Mailing Address - Street 2:
Mailing Address - City:NORLINA
Mailing Address - State:NC
Mailing Address - Zip Code:27536
Mailing Address - Country:US
Mailing Address - Phone:252-456-5200
Mailing Address - Fax:252-456-5219
Practice Address - Street 1:133 US 1 A
Practice Address - Street 2:
Practice Address - City:NORLINA
Practice Address - State:NC
Practice Address - Zip Code:27536
Practice Address - Country:US
Practice Address - Phone:252-456-5200
Practice Address - Fax:252-456-5219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-13
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No347B00000XTransportation ServicesBus