NPIMap

Organization Active NPI

Youth Development Corporation of America

Doing business as Crabtree Creek Clinic

  • Community/Behavioral Health Agency
  • Raleigh, NC
National Provider Identifier
1952518110
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
YOUTH DEVELOPMENT CORPORATION OF AMERICA
Doing business as
Crabtree Creek Clinic
Practice address
4000 Blue Ridge Rd
Suite 200
Raleigh, NC 27612-4650
Phone
(919) 782-4981
Fax
(919) 782-2474
NPI assigned
May 17, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sean Schreiber
Title
Development Director
Phone
(919) 323-8081

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NC Primary

Addresses

Primary practice location

4000 Blue Ridge Rd
Suite 200
Raleigh, NC 27612-4650

Mailing address

6015 Fayetteville Rd
Suite 211
Durham, NC 27713-6254
Phone (919) 323-8081

Other names 1

  • Crabtree Creek Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Caring Family Network17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952518110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 FAYETTEVILLE RD",
            "address_2": "SUITE 211",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136254",
            "telephone_number": "919-323-8081",
            "fax_number": "919-572-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 BLUE RIDGE RD",
            "address_2": "SUITE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124650",
            "telephone_number": "919-782-4981",
            "fax_number": "919-782-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH DEVELOPMENT CORPORATION OF AMERICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHREIBER",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "DEVELOPMENT DIRECTOR",
        "authorized_official_telephone_number": "919-323-8081"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crabtree Creek Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.