Healthcare Provider Details

I. General information

NPI: 1518369453
Provider Name (Legal Business Name): CHRISTINA MORRIS MINISTRIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2014
Last Update Date: 02/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 CALVIN ST
HARRINGTON DE
19952-1169
US

IV. Provider business mailing address

307 CALVIN ST
HARRINGTON DE
19952-1169
US

V. Phone/Fax

Practice location:
  • Phone: 302-604-4795
  • Fax:
Mailing address:
  • Phone: 302-604-4795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberCADC-144 & CCDP-1277
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberCADC-144 & CCDP-1277
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License NumberCADC-144 & CCDP-1277
License Number StateDE
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberCADC-144 & CCDP-1277
License Number StateDE

VIII. Authorized Official

Name: CHRISTINA MORRIS
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 302-362-7242