Provider Demographics
NPI:1528253770
Name:CENTER FOR STUDENT SUCCESS
Entity type:Organization
Organization Name:CENTER FOR STUDENT SUCCESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIERE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-680-8940
Mailing Address - Street 1:324 BLACKWELL ST
Mailing Address - Street 2:SUITE 1240
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707
Mailing Address - Country:US
Mailing Address - Phone:919-680-8921
Mailing Address - Fax:919-680-8949
Practice Address - Street 1:324 BLACKWELL ST
Practice Address - Street 2:SUITE 1240
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707
Practice Address - Country:US
Practice Address - Phone:919-680-8921
Practice Address - Fax:919-680-8949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300125261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center