Successful Start LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-041-888 Issued in NC

Legal business name

SUCCESSFUL START LLC

Practice address

2309 Williams Ave
High Point, NC 27262-3548

Phone

(336) 886-5611

Fax

(336) 886-5616

NPI assigned

Jan 27, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Khalid Tsalani Greenaway

Title

Owner

Phone

(336) 253-5286

Specialties & licenses 2

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258416000000",
    "number": "1518105642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13512",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274153512",
            "telephone_number": "336-253-5286",
            "fax_number": "336-886-5616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 WILLIAMS AVE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272623548",
            "telephone_number": "336-886-5611",
            "fax_number": "336-886-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUCCESSFUL START LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-27",
        "last_updated": "2009-11-17",
        "status": "A",
        "authorized_official_last_name": "GREENAWAY",
        "authorized_official_first_name": "KHALID",
        "authorized_official_middle_name": "TSALANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-253-5286",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-041-888",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-041-888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES LICENSURE NUMBER",
            "identifier": "MHL-041-888",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES FACILITY ID",
            "identifier": "080665",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jessica Subroto
• Shelby Jordan Subry, PA-C
• Successful Solutions, Inc
• Successful Transitions LLC
• Successful Transitions LLC
• Successful Youth Unlimited, Inc
• Caroline E Suddath, PA-C
• Tamika Wright Sudderth, RPH

• Emotionally Disturbed Childrens' Residential Treatment Facility in High Point, NC
• Providers in High Point, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.