Provider Demographics
NPI:1164556809
Name:ABC'S OF DEVELOPMENT, LLC
Entity Type:Organization
Organization Name:ABC'S OF DEVELOPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:SCALF
Authorized Official - Last Name:PRIEST
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:252-229-0310
Mailing Address - Street 1:5116 WHITE OAK DR
Mailing Address - Street 2:
Mailing Address - City:TRENT WOODS
Mailing Address - State:NC
Mailing Address - Zip Code:28562-6731
Mailing Address - Country:US
Mailing Address - Phone:252-229-0310
Mailing Address - Fax:
Practice Address - Street 1:5116 WHITE OAK DR
Practice Address - Street 2:
Practice Address - City:TRENT WOODS
Practice Address - State:NC
Practice Address - Zip Code:28562-6731
Practice Address - Country:US
Practice Address - Phone:252-229-0310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
NCC008271251S00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300700Medicaid