Provider Demographics
NPI:1427410711
Name:CREATIVE APPROACH DEVELOPMENT CENTER, LLC
Entity Type:Organization
Organization Name:CREATIVE APPROACH DEVELOPMENT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, BEHAVIOR AND EDUCATION CO
Authorized Official - Prefix:DR
Authorized Official - First Name:ZIPPORAH
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LEVI-SHACKLEFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PBSF
Authorized Official - Phone:804-876-2115
Mailing Address - Street 1:2819 N PARHAM RD STE 150
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4452
Mailing Address - Country:US
Mailing Address - Phone:804-876-2115
Mailing Address - Fax:804-386-6899
Practice Address - Street 1:2819 N PARHAM RD STE 150
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4452
Practice Address - Country:US
Practice Address - Phone:804-876-2115
Practice Address - Fax:804-386-6899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-24
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Single Specialty