Provider Demographics
NPI:1205388014
Name:WILLIAM FAMILY DEVELOPMENT LLC
Entity Type:Organization
Organization Name:WILLIAM FAMILY DEVELOPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANCINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-905-5688
Mailing Address - Street 1:PO BOX 49132
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-0074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11430 COREOPSIS RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-9261
Practice Address - Country:US
Practice Address - Phone:704-905-5688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency