Healthcare Provider Details

I. General information

NPI: 1407990526
Provider Name (Legal Business Name): HOWARD J. WESTON COMMUNITY AND SENIOR CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BASSETT AVE MANOR PARK
NEW CASTLE DE
19720-1906
US

IV. Provider business mailing address

1 BASSETT AVE MANOR PARK
NEW CASTLE DE
19720-1906
US

V. Phone/Fax

Practice location:
  • Phone: 302-328-6425
  • Fax: 302-328-6422
Mailing address:
  • Phone: 302-328-6425
  • Fax: 302-328-6422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberADULT DAY ADC-015
License Number StateDE

VIII. Authorized Official

Name: MS. AMY ELIZABETH DILL
Title or Position: DIRECTOR
Credential: RN
Phone: 302-328-6425