<Unavail>

LBN: Success Dynamics Community Development Corporation
<Unavail> is an health care organization with primary practice located at 7227 Statonsburg Road , Farmville NC 27828-0214. The organization recently has only one registered license in Agencies / Case Management, which is considered as the primary health care specialty. Success Dynamics Community Development Corporation can be contacted via phone (252) 753-7815, or through Ellison, Calvin O. via phone (252) 753-7815.

Contact Information

Primary practice address
7227 Statonsburg Road Farmville NC 27828-0214
Phone: (252) 753-7815
Fax: (252) 753-8787
Website:
Map and Directions
Authorized official contact:
Name: Ellison, Calvin O. N.D., PHD
Phone: (252) 753-7815

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X North Carolina

Profile Details

NPI number 1215114715
LBN Legal business name Success Dynamics Community Development Corporation
DBA Doing business as <Unavail>
Authorized official Ellison, Calvin O. N.D., PHD
Entity Organization
Organization subpart 1 No
Enumeration date Jan 28th, 2008
Last updated Jul 22nd, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215114715 NPPES
North Carolina MEDICAID 8700515

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