Provider Demographics
NPI:1104071687
Name:CENTER FOR DEVELOPMENT AND LEARNING
Entity type:Organization
Organization Name:CENTER FOR DEVELOPMENT AND LEARNING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BODFISH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:919-966-4896
Mailing Address - Street 1:143 W FRANKLIN ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-2539
Mailing Address - Country:US
Mailing Address - Phone:919-966-4896
Mailing Address - Fax:
Practice Address - Street 1:1450 RALEIGH RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8833
Practice Address - Country:US
Practice Address - Phone:919-966-4896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNC PHYSICIANS AND ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1466261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities