Healthcare Provider Details

I. General information

NPI: 1346158284
Provider Name (Legal Business Name): DELAWARE INCLUSIVE FITNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 CORWIN CT
BEAR DE
19701-4869
US

IV. Provider business mailing address

609 CORWIN CT
BEAR DE
19701-4869
US

V. Phone/Fax

Practice location:
  • Phone: 302-757-6254
  • Fax:
Mailing address:
  • Phone: 302-757-6254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. NGANO TONY KING SR.
Title or Position: CHEIF EXECUTIVE OFFICER
Credential:
Phone: 302-757-6254