Healthcare Provider Details

I. General information

NPI: 1255589982
Provider Name (Legal Business Name): GHR CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2008
Last Update Date: 09/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 PINE CONE DR NONE
DOVER DE
19901-1976
US

IV. Provider business mailing address

191 PINE CONE DR NONE
DOVER DE
19901-1976
US

V. Phone/Fax

Practice location:
  • Phone: 302-670-9822
  • Fax:
Mailing address:
  • Phone: 302-670-9822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License NumberL20002979
License Number StateDE

VIII. Authorized Official

Name: MRS. SUSAN HUGHES SWANN
Title or Position: LPN
Credential: NURSINFG LIC.
Phone: 302-670-9822