Healthcare Provider Details

I. General information

NPI: 1376846816
Provider Name (Legal Business Name): HOLCOMB ASSOCIATES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2010
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 WALKER RD
DOVER DE
19904-6600
US

IV. Provider business mailing address

1151 WALKER RD
DOVER DE
19904-6600
US

V. Phone/Fax

Practice location:
  • Phone: 302-678-4911
  • Fax: 302-678-4948
Mailing address:
  • Phone: 302-678-4911
  • Fax: 302-678-4948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TERESA JACKSON
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 610-363-1488