SUCCESS HEALTH SYSTEM LLC NPI 1508310293

NPI Information

NPI: 1508310293
Provider Name: SUCCESS HEALTH SYSTEM, LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
607 TEACO RD
KENNETT, MO
ZIP 63857
Phone: (972) 974-0109
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SUCCESS HEALTH SYSTEM, LLC is a mental health counselor in Kennett, MO. SUCCESS HEALTH SYSTEM, LLC NPI is 1508310293. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

607 TEACO RD
KENNETT, MO
ZIP 63857-723
Phone: (972) 974-0109
Fax: (573) 271-5108

The provider's authorized official is Moses Tabe Ambilichu .
The authorized official title is Md and has the following contact phone number (972) 974-0109.

The enumeration date for this NPI number is 8/10/2016 and was last updated on 8/10/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	2011019835	MISSOURI	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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