Healthcare Provider Details

I. General information

NPI: 1447063490
Provider Name (Legal Business Name): THE NEMOURS FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 ROCKLAND RD STE 302
WILMINGTON DE
19803-3648
US

IV. Provider business mailing address

PO BOX 404112
ATLANTA GA
30384-4112
US

V. Phone/Fax

Practice location:
  • Phone: 302-651-4200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK MUMFORD
Title or Position: EXECUTIVE VP, COO
Credential:
Phone: 302-651-6890