Provider Demographics
NPI:1558142430
Name:DEVELOPMENT ACADEMY CORPORATION
Entity Type:Organization
Organization Name:DEVELOPMENT ACADEMY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADVISOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-503-5254
Mailing Address - Street 1:2414 ARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-9577
Mailing Address - Country:US
Mailing Address - Phone:502-910-1117
Mailing Address - Fax:
Practice Address - Street 1:1732 BELLEFONTAINE ST APT 4
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1813
Practice Address - Country:US
Practice Address - Phone:317-503-5254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1689454126OtherNPI