Provider Demographics
NPI:1154463446
Name:YOUTH DEVELOPMENT CORPORATION OF AMERICA
Entity Type:Organization
Organization Name:YOUTH DEVELOPMENT CORPORATION OF AMERICA
Other - Org Name:CARING FAMILY NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING SPECIALIST SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:BRELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:WADDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-323-8090
Mailing Address - Street 1:6050 SIX FORKS RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-8601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6050 SIX FORKS RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-8601
Practice Address - Country:US
Practice Address - Phone:919-870-8699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency