Healthcare Provider Details

I. General information

NPI: 1972290179
Provider Name (Legal Business Name): ATRACARE MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1532 SAVANNAH RD STE A
LEWES DE
19958-1624
US

IV. Provider business mailing address

18068 COASTAL HWY
LEWES DE
19958-4901
US

V. Phone/Fax

Practice location:
  • Phone: 302-567-1500
  • Fax:
Mailing address:
  • Phone: 302-567-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM ALBANESE III
Title or Position: CEO
Credential: PHARMD
Phone: 302-567-1500