| Odessa House Rtc | |
|
493 E Main St Middletown DE 19709-1463 | |
| (302) 378-5226 | |
| Not Available |
| Full Name | Odessa House Rtc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 493 E Main St, Middletown, Delaware |
| Authorized Official Name and Position | Josette Manning (CABINET SECRETARY) |
| Authorized Official Contact | 3026332500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Odessa House Rtc 493 E Main St Middletown DE 19709-1463 Ph: (302) 378-5226 | Odessa House Rtc 493 E Main St Middletown DE 19709-1463 Ph: (302) 378-5226 |
| NPI Number | 1164501318 |
|---|---|
| Provider Enumeration Date | 11/06/2006 |
| Last Update Date | 01/09/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164501318 | NPI | - | NPPES |
| 0000489267 | Medicaid | DE | |
| 0690004200 | Other | DE | CYC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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