Success Residence LLC
NPI #1225621485 in San Tan Valley, Arizona
Provider Information
- NPI Number
- 1225621485
- Entity Type
- Organization
- Organization Name
- Success Residence LLC
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Enumeration Date
- Feb 18, 2021
- Last Updated
- Feb 18, 2021
Practice Location
- Address
- 5120 E WALLACE WAY
- City
- San Tan Valley
- State
- Arizona
- ZIP Code
- 85143-5161
- Phone
- (917) 891-4320
Authorized Official
- Name
- MAAMA ABUKARI, MD
- Title
- ADMINISTRATOR
- Phone
- (917) 891-4320
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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