Provider Demographics
NPI:1629301122
Name:EDUCATION 1ST ACADEMY LLC
Entity Type:Organization
Organization Name:EDUCATION 1ST ACADEMY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FASHENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-695-2380
Mailing Address - Street 1:1219 ROCKINGHAM RD
Mailing Address - Street 2:STE 6
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-4983
Mailing Address - Country:US
Mailing Address - Phone:704-695-2380
Mailing Address - Fax:704-983-0681
Practice Address - Street 1:1219 ROCKINGHAM RD
Practice Address - Street 2:STE 6
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4983
Practice Address - Country:US
Practice Address - Phone:704-695-2380
Practice Address - Fax:704-983-0681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health