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SUPREME YOUTH DEVELOPMENT CENTER NPI 1043447733


NPI Information

NPI: 1043447733
Provider Name: SUPREME YOUTH DEVELOPMENT CENTER
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
4704 COURTNEY LN APT C
RALEIGH, NC
ZIP 27616
Phone: (919) 824-0891
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SUPREME YOUTH DEVELOPMENT CENTER is a community behavioral health in Raleigh, NC. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. SUPREME YOUTH DEVELOPMENT CENTER NPI is 1043447733. The provider is registered as an organization entity type.

The provider's business location address is:

4704 COURTNEY LN APT C
RALEIGH, NC
ZIP 27616-251
Phone: (919) 824-0891
Fax: (919) 803-2356

The provider's authorized official is Kelly Louise Broady .
The authorized official title is Ceo/founder and has the following contact phone number (919) 824-0891.

The enumeration date for this NPI number is 6/19/2009 and was last updated on 6/19/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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