Organization
AGES AND STAGES ABA STRATEGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEMETRIA WADDELL (DIRECTOR)
(708) 362-1697
Entity
Organization
Contact information
Practice address
2997 NC HIGHWAY 210 W, HAMPSTEAD, NC 28443-3481
(708) 362-1697
Mailing address
2997 NC HIGHWAY 210 W, HAMPSTEAD, NC 28443-3481
(708) 362-1697
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
342000000X
Transportation Network Company
—
—
385H00000X
Respite Care
—
—
385HR2050X
Respite Care Camp
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
09/26/2023
Last updated
01/16/2026
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