Healthcare Provider Details

I. General information

NPI: 1326183674
Provider Name (Legal Business Name): KENT SUSSEX COMMUNITY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 10/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1241 COLLEGE PARK DR
DOVER DE
19904-8713
US

IV. Provider business mailing address

1241 COLLEGE PARK DR
DOVER DE
19904-8713
US

V. Phone/Fax

Practice location:
  • Phone: 302-735-7790
  • Fax: 302-735-3654
Mailing address:
  • Phone: 302-735-7790
  • Fax: 302-735-3654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License NumberCL0001
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License NumberCL0123
License Number StateDE

VIII. Authorized Official

Name: MR. DAVID WALTON PARCHER
Title or Position: EXECUTIVE DIRECTOR
Credential: M.A., L.P.C.M.H.
Phone: 302-735-7790