Provider Demographics
NPI:1114005543
Name:SOUTHWESTERN CHILD DEVELOPMENT COMMISSION, INC.
Entity Type:Organization
Organization Name:SOUTHWESTERN CHILD DEVELOPMENT COMMISSION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACT SERVICES MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:H
Authorized Official - Last Name:LAUFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-586-5561
Mailing Address - Street 1:142 E SYLVA SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-5169
Mailing Address - Country:US
Mailing Address - Phone:828-586-5561
Mailing Address - Fax:828-631-1860
Practice Address - Street 1:142 E SYLVA SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-5169
Practice Address - Country:US
Practice Address - Phone:828-586-5561
Practice Address - Fax:828-631-1860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300038BMedicaid
NC8300038KMedicaid
NC8300038Medicaid