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Organization
TEAM SUCCESS LLC
Active
Organization
TEAM SUCCESS LLC
Active
Other names
Team Success Youth Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DWAYNE ANTHONY HERBERT BBA, MBA (EXECUTIVE DIRECTOR)
(704) 668-3573
Entity
Organization
Contact information
Practice address
3393 STARTOWN RD, NEWTON, NC 28658-9216
(704) 668-3573
Mailing address
251 N HIGHWAY 16, APT. 14, DENVER, NC 28037-5004
(704) 668-3573
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-018-086
NC
Other
Enumeration date
10/15/2008
Last updated
10/15/2008
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