Success for Life Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SUCCESS FOR LIFE INC

Practice address

4627 N Sharon Amity Rd
Charlotte, NC 28205-4676

Phone

(704) 299-1263

NPI assigned

Nov 16, 2017

Last updated

Nov 16, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Pervis Nash

Title

Ceo

Phone

(704) 299-1263

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510790400000",
    "number": "1881108512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4627 N SHARON AMITY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282054676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4627 N SHARON AMITY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282054676",
            "telephone_number": "704-299-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUCCESS FOR LIFE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-16",
        "last_updated": "2017-11-16",
        "status": "A",
        "authorized_official_last_name": "NASH",
        "authorized_official_first_name": "PERVIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-299-1263"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; 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.