Healthcare Provider Details

I. General information

NPI: 1326660895
Provider Name (Legal Business Name): LIFE AT ST. FRANCIS HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2020
Last Update Date: 05/07/2020
Certification Date: 05/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 EXECUTIVE DRIVE
NEWARK DE
19702
US

IV. Provider business mailing address

1072 JUSTISON ST
WILMINGTON DE
19801-5162
US

V. Phone/Fax

Practice location:
  • Phone: 302-660-3351
  • Fax:
Mailing address:
  • Phone: 302-421-4956
  • Fax: 302-575-8239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MS. CLARE MARIE THOMAS
Title or Position: DIR QA, COMPLIANCE, CREDENTIALING
Credential: RN,MS
Phone: 302-747-3336