Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Intellectual & Developmental Disabilities |
103TM1800X | 62 | Psychologist, Clinical | |
Nursing Facility/Intermediate Care Facility |
313M00000X | A3[10] | Other Nursing Facility |
| NPI Number | 1265785638 |
| LBN Legal business name | SUCCESS HEALTHCARE RESOURCES |
| Authorized official | LAURA EMOKPAE - (ADMINISTRATOR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 10/22/2012 |
| Last updated | 10/24/2012 - About 14 years ago |
| Identifiers | n/a |
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