Provider Demographics
NPI:1861261356
Name:SUCCESS NEWNAN LLC
Entity type:Organization
Organization Name:SUCCESS NEWNAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEIGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-372-6480
Mailing Address - Street 1:1282 PRECIOUS COURT
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755
Mailing Address - Country:US
Mailing Address - Phone:845-372-6480
Mailing Address - Fax:
Practice Address - Street 1:1625 E HWY 34
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-1325
Practice Address - Country:US
Practice Address - Phone:770-615-8989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-26
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty