Provider Demographics
NPI:1497063184
Name:CHILDREN'S CENTER FOR DEVELOPMENT AND BEHAVIOR
Entity Type:Organization
Organization Name:CHILDREN'S CENTER FOR DEVELOPMENT AND BEHAVIOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNT REPRESENTATIVE
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:METER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-745-1112
Mailing Address - Street 1:440 SAWGRASS CORPORATE PKWY STE 106
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-6236
Mailing Address - Country:US
Mailing Address - Phone:954-745-1112
Mailing Address - Fax:954-745-1120
Practice Address - Street 1:440 SAWGRASS CORPORATE PKWY STE 106
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33325-6236
Practice Address - Country:US
Practice Address - Phone:954-745-1112
Practice Address - Fax:954-745-1120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103TB0200X252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency