Success Behavioral Group Home LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SUCCESS BEHAVIORAL GROUP HOME LLC

Practice address

8733 W Cordes Rd
Tolleson, AZ 85353-8606

Phone

(602) 558-5847

Fax

(602) 671-6752

NPI assigned

Nov 24, 2021

Organization subpart

No

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

Authorized official

Name

Emmanuel Israel Omasere

Title

Chief Executive Officer

Phone

(602) 558-5847

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637712000000",
    "number": "1942967989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8733 W CORDES RD",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853538606",
            "telephone_number": "602-558-5847",
            "fax_number": "602-671-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8733 W CORDES RD",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853538606",
            "telephone_number": "602-558-5847",
            "fax_number": "602-671-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUCCESS BEHAVIORAL GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-24",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A",
        "authorized_official_last_name": "OMASERE",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_middle_name": "ISRAEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "602-558-5847"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skyler Blue Family Chiropractic LLC
• Sneakaheadz LLC
• Speechy Keen Therapy LLC
• Sterling-S Haven
• Genesis Estrella Strouse
• Success Behavioral Group Home LLC 1
• Sunrise Behavior Health Home LLC
• Sunshine Adult Day Program LLC
• Sunshine Medical Transportation LLC
• Supreme Health and Wellness

• Community/Behavioral Health Agency in Tolleson, AZ
• Providers in Tolleson, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.