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General NPI Number Information
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NPI Number | 1427410711
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Entity Type | Organization
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Legal Business Name | CREATIVE APPROACH DEVELOPMENT CENTER, LLC
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Dates
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Enumeration Date | 03/24/2016
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 2819 N PARHAM RD STE 150
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City | HENRICO
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State | VA
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Zip | 23294-4452
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Country | US
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Telephone | 804-876-2115
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Fax | 804-386-6899
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Provider Business Mailing Address
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Address Line | 2819 N PARHAM RD STE 150
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City | HENRICO
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State | VA
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Zip | 23294-4452
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Country | US
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Telephone | 804-876-2115
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Fax | 804-386-6899
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Authorized Official
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Title or Position | FOUNDER, BEHAVIOR AND EDUCATION CO
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Name | DR. ZIPPORAH LEE LEVI-SHACKLEFORD
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Credential | PBSF
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Telephone | 804-876-2115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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