Healthcare Provider Details

I. General information

NPI: 1518575596
Provider Name (Legal Business Name): COLLABORATIVE EFFORT TO REINFORCE TRANSITION SUCCESS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2020
Last Update Date: 03/08/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 READS WAY
NEW CASTLE DE
19720-1649
US

IV. Provider business mailing address

52 READS WAY
NEW CASTLE DE
19720-1649
US

V. Phone/Fax

Practice location:
  • Phone: 302-731-0301
  • Fax: 302-731-0201
Mailing address:
  • Phone: 302-731-0301
  • Fax: 302-731-0201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225CX0006X
TaxonomyOrientation and Mobility Training Rehabilitation Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. VIVIAN J. TURNER
Title or Position: EXECUTIVE DIRECTOR
Credential: MPA
Phone: 302-731-0301