CCDP INC. NPI 1316090509

NPI Information

  • NPI: 1316090509
  • Provider Name: CCDP INC.
  • Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
  • Entity Type: Organization
  • Doing Business As: COASTAL CHILDREN'S DEVELOPMENTAL PROGRAM INC.
  • Address: 2961 HWY 58 SOUTH
    POLLOCKSVILLE, NC
    ZIP 28573
  • Phone: (252) 224-0320

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NPI Details

CCDP INC. is a residential treatment facility emotionally disturbed children in Pollocksville, NC. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. CCDP INC. NPI is 1316090509. The provider is registered as an organization entity type.
The provider Is Doing Business As Coastal Children's Developmental Program Inc..

The provider's business location address is:

2961 HWY 58 SOUTH
POLLOCKSVILLE, NC
ZIP 28573-755
Phone: (252) 224-0320
Fax: (252) 224-0320

The provider's authorized official is Donna B Davis .
The authorized official title is Assistant Director and has the following contact phone number (252) 638-9046.

The enumeration date for this NPI number is 1/19/2007 and was last updated on 6/16/2008.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenMHL052-011NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
16603132MEDICAIDNORTH CAROLINA

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: 11/21/2025

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