Provider Demographics
NPI:1093138877
Name:SUCCESS ADOLESCENT AND ADULT SERVICES INC.
Entity type:Organization
Organization Name:SUCCESS ADOLESCENT AND ADULT SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:URETHA
Authorized Official - Last Name:PASTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, CCM
Authorized Official - Phone:910-286-6559
Mailing Address - Street 1:35 HAWK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NC
Mailing Address - Zip Code:28390-7050
Mailing Address - Country:US
Mailing Address - Phone:910-286-6559
Mailing Address - Fax:
Practice Address - Street 1:665 E SAUNDERS STREET
Practice Address - Street 2:
Practice Address - City:MAXTON
Practice Address - State:NC
Practice Address - Zip Code:28364
Practice Address - Country:US
Practice Address - Phone:910-317-0323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC145300251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health