Healthcare Provider Details

I. General information

NPI: 1235294380
Provider Name (Legal Business Name): INTERIM HEALTHCARE OF DELAWARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 N HIGH STREET EXTENDED
SMYRNA DE
19977-1183
US

IV. Provider business mailing address

92 READS WAY UNIT 108
NEW CASTLE DE
19720-1631
US

V. Phone/Fax

Practice location:
  • Phone: 302-322-2743
  • Fax: 302-328-5086
Mailing address:
  • Phone: 302-322-2743
  • Fax: 302-328-5086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHAS-029A
License Number StateDE

VIII. Authorized Official

Name: MR. NICHOLAS ANTHONY MANNINO JR.
Title or Position: PRESIDENT
Credential:
Phone: 302-322-2743