Healthcare Provider Details

I. General information

NPI: 1619703337
Provider Name (Legal Business Name): CAREBRIDGE HEALTH SYSTEMS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2024
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 SHANNON BLVD
MIDDLETOWN DE
19709-2191
US

IV. Provider business mailing address

157 SHANNON BLVD
MIDDLETOWN DE
19709-2191
US

V. Phone/Fax

Practice location:
  • Phone: 302-747-0150
  • Fax:
Mailing address:
  • Phone: 302-747-0150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MR. GERSHOM SOIRE
Title or Position: OWNER
Credential:
Phone: 302-747-0150