Healthcare Provider Details

I. General information

NPI: 1992863583
Provider Name (Legal Business Name): COMMUNITY SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 CORPORATE BLVD STE A
NEWARK DE
19702-3329
US

IV. Provider business mailing address

250 CORPORATE BLVD STE A
NEWARK DE
19702-3329
US

V. Phone/Fax

Practice location:
  • Phone: 302-368-2621
  • Fax: 302-456-5733
Mailing address:
  • Phone: 302-368-2621
  • Fax: 302-456-5733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number1243
License Number StateDE

VIII. Authorized Official

Name: MR. DAVID PAIGE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 302-368-2621