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540 S College Ave Ste 160 Newark DE 19713-1302 | |
| (302) 831-8893 | |
| (302) 831-4468 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Rehabilitation |
| Location | 540 S College Ave Ste 160, Newark, Delaware |
| Authorized Official Name and Position | Airelle Hunter (DIRECTOR OF CLINICAL SERVICES) |
| Authorized Official Contact | 3028312705 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
540 S College Ave Ste 160 Newark DE 19713-1302 Ph: (302) 831-8893 | 540 S College Ave Ste 160 Newark DE 19713-1302 Ph: (302) 831-8893 |
| NPI Number | 1679614390 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 11/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679614390 | NPI | - | NPPES |
| 1000035397 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QR0400X | Clinic/center - Rehabilitation | J1-0000851 (Delaware) | Primary |
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