Healthcare Provider Details

I. General information

NPI: 1417863820
Provider Name (Legal Business Name): GIRLS LEADERSHIP ACADEMY OF WILMINGTON FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 SUNGLOW DR
WILMINGTON NC
28405-1376
US

IV. Provider business mailing address

4100 SUNGLOW DR
WILMINGTON NC
28405-1376
US

V. Phone/Fax

Practice location:
  • Phone: 910-338-5258
  • Fax:
Mailing address:
  • Phone: 910-338-5258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: TODD GODBEY
Title or Position: CEO
Credential:
Phone: 910-338-5258