Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
SUPREME YOUTH DEVELOPMENT CENTER
Active
Organization
SUPREME YOUTH DEVELOPMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLY LOUISE BROADY BSW (CEO/FOUNDER)
(919) 824-0891
Entity
Organization
Contact information
Practice address
4704 COURTNEY LN APT C, RALEIGH, NC 27616-5251
(919) 824-0891
(919) 803-2356
Mailing address
4704 COURTNEY LN APT C, RALEIGH, NC 27616-5251
(919) 824-0891
(919) 803-2356
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/19/2009
Last updated
06/19/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up