Provider Demographics
NPI:1508944745
Name:ST. MARY'S CHILD DEVELOPMENT CENTER, INC.
Entity Type:Organization
Organization Name:ST. MARY'S CHILD DEVELOPMENT CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-882-6413
Mailing Address - Street 1:5325 GREENWOOD AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2452
Mailing Address - Country:US
Mailing Address - Phone:561-881-2822
Mailing Address - Fax:
Practice Address - Street 1:5325 GREENWOOD AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2452
Practice Address - Country:US
Practice Address - Phone:561-881-2822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management