Provider Demographics
NPI:1467810820
Name:SPORTS HELPING EDUCATE AND DEVELOP, INC
Entity Type:Organization
Organization Name:SPORTS HELPING EDUCATE AND DEVELOP, INC
Other - Org Name:S.H.E.D., INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:FOUNDER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHEDRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-491-0415
Mailing Address - Street 1:5736 N TRYON ST
Mailing Address - Street 2:SUITE 204-A
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-6850
Mailing Address - Country:US
Mailing Address - Phone:704-491-0415
Mailing Address - Fax:
Practice Address - Street 1:5736 N TRYON ST
Practice Address - Street 2:SUITE 204-A
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-6850
Practice Address - Country:US
Practice Address - Phone:704-491-0415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization