Healthcare Provider Details

I. General information

NPI: 1619887817
Provider Name (Legal Business Name): MISSION OF KINDNESS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 WELLSPRING DR
BEAR DE
19701-1360
US

IV. Provider business mailing address

27 WELLSPRING DR
BEAR DE
19701-1360
US

V. Phone/Fax

Practice location:
  • Phone: 302-390-7580
  • Fax:
Mailing address:
  • Phone: 302-390-7580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: TINA J INNIS
Title or Position: CEO/EXECUTIVE DIRECTOR
Credential:
Phone: 646-546-3989