Organization
SUCCESS RESIDENCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAAMA ABUKARI (EMPLOYEE)
(917) 891-4320
Entity
Organization
Contact information
Practice address
2408 E OLIVINE RD, SAN TAN VALLEY, AZ 85143-4908
(917) 891-4320
Mailing address
5120 E WALLACE WAY, SAN TAN VALLEY, AZ 85143-5161
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/08/2023
Last updated
06/08/2023
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