Provider Demographics
NPI:1417683467
Name:A SPROUT AHEAD EARLY INTERVENTION, LLC
Entity Type:Organization
Organization Name:A SPROUT AHEAD EARLY INTERVENTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EI SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:COTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-630-5495
Mailing Address - Street 1:130 BROOKHILL PL
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-3217
Mailing Address - Country:US
Mailing Address - Phone:864-630-5495
Mailing Address - Fax:
Practice Address - Street 1:130 BROOKHILL PL
Practice Address - Street 2:
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662-3217
Practice Address - Country:US
Practice Address - Phone:864-630-5495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-30
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency