| Successful Start Llc | |
|
2309 Williams Ave High Point NC 27262-3548 | |
| (336) 886-5611 | |
| (336) 886-5616 |
| Full Name | Successful Start Llc |
|---|---|
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
| Location | 2309 Williams Ave, High Point, North Carolina |
| Authorized Official Name and Position | Khalid Tsalani Greenaway (OWNER) |
| Authorized Official Contact | 3362535286 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Successful Start Llc Po Box 13512 Greensboro NC 27415-3512 Ph: (336) 253-5286 | Successful Start Llc 2309 Williams Ave High Point NC 27262-3548 Ph: (336) 886-5611 |
| NPI Number | 1518105642 |
|---|---|
| Provider Enumeration Date | 01/27/2009 |
| Last Update Date | 11/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518105642 | NPI | - | NPPES |
| MHL-041-888 | Other | NC | STATE OF NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES LICENSURE NUMBER |
| 080665 | Other | NC | STATE OF NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES FACILITY ID |
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