Healthcare Provider Details

I. General information

NPI: 1114005543
Provider Name (Legal Business Name): SOUTHWESTERN CHILD DEVELOPMENT COMMISSION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 09/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 E SYLVA SHOPPING CTR
SYLVA NC
28779-5169
US

IV. Provider business mailing address

142 E SYLVA SHOPPING CTR
SYLVA NC
28779-5169
US

V. Phone/Fax

Practice location:
  • Phone: 828-586-5561
  • Fax: 828-631-1860
Mailing address:
  • Phone: 828-586-5561
  • Fax: 828-631-1860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHARON H. LAUFFER
Title or Position: CONTRACT SERVICES MANAGER
Credential:
Phone: 828-586-5561