MEDICARE: CHRISTIANA CARE HEALTH SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor
3	103T00000X	Psychologist
4	103T00000X	Psychologist	DE
5	104100000X	Social Worker
6	1041C0700X	Clinical Social Worker
7	106H00000X	Marriage & Family Therapist
8	363A00000X	Physician Assistant
9	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
10	364SP0808X	Psychiatric/Mental Health Clinical Nurse Specialist
11	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist
12	2084P0800X	Psychiatry Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083699433
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTIANA CARE HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 30170
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19805-7170
Country	:	US
Telephone Number	:	302-623-7000
Fax Number	:	302-623-7374

Provider Business Practice Location Address
First Line	:	501 W 14TH ST
Second Line	:	WILMINGTON HOSPITAL
City	:	WILMINGTON
State	:	DE
Zip	:	19801-1013
Country	:	US
Telephone Number	:	302-428-2100
Fax Number	:	302-428-2121

Authorized Official
Title or Position	:	CFO
Name	:	ROBERT W MCMURRAY JR.
Credential	:
Telephone Number	:	302-428-2522

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	11/07/2022

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