Basic Information
Provider Information
NPI: 1891898367
EntityType: 2
ReplacementNPI:  
OrganizationName: CENTER FOR CHILD DEVELOPMENT
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5325 GREENWOOD AVE
Address2: SUITE 201
City: WEST PALM BEACH
State: FL
PostalCode: 334072452
CountryCode: US
TelephoneNumber: 5618812822
FaxNumber: 5618810972
Practice Location
Address1: 5325 GREENWOOD AVE
Address2: SUITE 201
City: WEST PALM BEACH
State: FL
PostalCode: 334072452
CountryCode: US
TelephoneNumber: 5618812822
FaxNumber: 5618810972
Other Information
ProviderEnumerationDate: 09/07/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: CHAPMAN
AuthorizedOfficialFirstName: PATRICIA
AuthorizedOfficialMiddleName: MORRIS
AuthorizedOfficialTitleorPosition: SOCIAL WORKER/CASE MANAGER
AuthorizedOfficialTelephone: 5618406660
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: BSW
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251B00000X  Y AgenciesCase Management 

No ID Information.


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