Healthcare Provider Details

I. General information

NPI: 1619179967
Provider Name (Legal Business Name): WANEL HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 SILVERHILL XING
MIDDLETOWN DE
19709-6842
US

IV. Provider business mailing address

504 SILVERHILL XING
MIDDLETOWN DE
19709-6842
US

V. Phone/Fax

Practice location:
  • Phone: 302-449-1904
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateDE

VIII. Authorized Official

Name: WATCHEN NELSON
Title or Position: PROGRAM COORDINATOR
Credential: R.N.
Phone: 302-449-1904