Provider Demographics
NPI:1578746848
Name:DEVELOPMENTAL PLAY
Entity Type:Organization
Organization Name:DEVELOPMENTAL PLAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-792-3020
Mailing Address - Street 1:1080 TAYLOR ESTATE RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-9655
Mailing Address - Country:US
Mailing Address - Phone:252-792-3020
Mailing Address - Fax:252-792-3020
Practice Address - Street 1:1080 TAYLOR ESTATE RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-9655
Practice Address - Country:US
Practice Address - Phone:252-792-3020
Practice Address - Fax:252-792-3020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency