1. Home
  2. Directory
  3. North Carolina
  4. Raleigh
  5. Community Behavioral Health
  6. NPI Profile

SUPREME YOUTH DEVELOPMENT CENTER
NPI 1043447733
Community/Behavioral Health in Raleigh, NC

Active since June 19, 2009
4704 COURTNEY LN APT C, RALEIGH, NC 27616(919) 824-0891(919) 803-2356 Get Directions Write a Review

NPPES record last updated: June 19, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Supreme Youth Development Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUPREME YOUTH DEVELOPMENT CENTER (NPI 1043447733) is a healthcare organization registered as a community/behavioral health in Raleigh, North Carolina and active in the NPI registry since June 2009. The organization lists Kelly Louise Broady, Ceo/founder, as its authorized official.

NPPES Registry Identity

NPI1043447733
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameSUPREME YOUTH DEVELOPMENT CENTER
Location Address4704 COURTNEY LN APT CRaleigh, NC 27616-5251
Mailing Address4704 Courtney Ln Apt CRaleigh, NC 27616-5251 · (919) 824-0891 · Fax (919) 803-2356
Phone(919) 824-0891
Fax(919) 803-2356
Organization SubpartNo
Authorized OfficialKelly Louise BroadyCeo/founder · (919) 824-0891
Enumeration DateJune 19, 2009
✔ NPI 1043447733 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
4704 COURTNEY LN APT C, Raleigh, NC 27616
Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Supreme Youth Development Center's NPI number?

The NPI number for Supreme Youth Development Center is 1043447733. It was assigned to this organization in the NPPES registry on June 19, 2009.

Where is Supreme Youth Development Center located?

Supreme Youth Development Center is located at 4704 Courtney Ln Apt C, Raleigh, NC 27616. The listed phone number is (919) 824-0891.

What is Supreme Youth Development Center's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Supreme Youth Development Center was last updated on June 19, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.