Healthcare Provider Details

I. General information

NPI: 1457678971
Provider Name (Legal Business Name): ATLANTIC HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 04/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 READS WAY STE 117
NEW CASTLE DE
19720-1608
US

IV. Provider business mailing address

2 READS WAY STE 117
NEW CASTLE DE
19720-1608
US

V. Phone/Fax

Practice location:
  • Phone: 302-322-3166
  • Fax: 302-322-3167
Mailing address:
  • Phone: 302-322-3166
  • Fax: 302-322-3167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2010601313
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number2010601313
License Number StateDE

VIII. Authorized Official

Name: MR. TUNDE AJANAKU
Title or Position: PRESIDENT
Credential:
Phone: 302-322-3166