Provider Demographics
NPI:1003459348
Name:CAROLINA THERAPLAY
Entity Type:Organization
Organization Name:CAROLINA THERAPLAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEVELOPMENTAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:ITFS
Authorized Official - Phone:336-906-7350
Mailing Address - Street 1:90 PINE WOOD DR
Mailing Address - Street 2:
Mailing Address - City:SILER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344-7804
Mailing Address - Country:US
Mailing Address - Phone:336-906-7350
Mailing Address - Fax:
Practice Address - Street 1:90 PINE WOOD DR
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-7804
Practice Address - Country:US
Practice Address - Phone:336-906-7350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency