Healthcare Provider Details

I. General information

NPI: 1164556809
Provider Name (Legal Business Name): ABC'S OF DEVELOPMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 04/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5116 WHITE OAK DR
TRENT WOODS NC
28562-6731
US

IV. Provider business mailing address

5116 WHITE OAK DR
TRENT WOODS NC
28562-6731
US

V. Phone/Fax

Practice location:
  • Phone: 252-229-0310
  • Fax:
Mailing address:
  • Phone: 252-229-0310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberC008271
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberC008271
License Number StateNC

VIII. Authorized Official

Name: MRS. MARIA SCALF PRIEST
Title or Position: OWNER
Credential: MSW
Phone: 252-229-0310