Organization
SUCCESSFUL JOURNEYS, LLC
Active
Other names
Successful Journeys II
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID AGYAPONG MD (CEO)
(615) 310-6325
Entity
Organization
Contact information
Practice address
20969 W THOMAS RD, BUCKEYE, AZ 85396-1645
(623) 546-6545
(623) 321-3599
Mailing address
12224 N 45TH LN, GLENDALE, AZ 85304-2312
(623) 293-8022
(602) 693-0628
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH4830
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139413
—
AZ
Enumeration date
04/14/2016
Last updated
12/19/2023
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