Provider Demographics
NPI:1316060247
Name:HIGHER DEVELOPMENT LLC
Entity type:Organization
Organization Name:HIGHER DEVELOPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-974-1240
Mailing Address - Street 1:111 BEECH LN
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-9609
Mailing Address - Country:US
Mailing Address - Phone:252-974-1240
Mailing Address - Fax:
Practice Address - Street 1:111 BEECH LN
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-9609
Practice Address - Country:US
Practice Address - Phone:252-974-1240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-07
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL007061320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6604174Medicaid
NCMHL007061OtherLICENSE NUMBER
NC6604174Medicaid