Healthcare Provider Details

I. General information

NPI: 1356336622
Provider Name (Legal Business Name): CHANCELLOR CARE CENTER OF DELMAR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 DELAWARE AVE
DELMAR DE
19940-1110
US

IV. Provider business mailing address

12904 BUCKEYE DR
DARNESTOWN MD
20878-3532
US

V. Phone/Fax

Practice location:
  • Phone: 302-846-3077
  • Fax: 302-846-3148
Mailing address:
  • Phone: 302-846-3077
  • Fax: 302-846-3148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1028
License Number StateDE

VIII. Authorized Official

Name: MRS. DIANE LEE COLANGELO
Title or Position: ADMINISTRATOR
Credential:
Phone: 302-846-3077