Healthcare Provider Details

I. General information

NPI: 1235837956
Provider Name (Legal Business Name): MARQUEE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 09/01/2024
Certification Date: 09/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PLEASANT PL
NEW CASTLE DE
19720-3005
US

IV. Provider business mailing address

1 PLEASANT PL
NEW CASTLE DE
19720-3005
US

V. Phone/Fax

Practice location:
  • Phone: 302-499-4100
  • Fax: 916-330-3218
Mailing address:
  • Phone: 302-499-4100
  • Fax: 916-330-3218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
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

VIII. Authorized Official

Name: OLUWADAMILARE SHONEYE
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 302-499-4100