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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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