Healthcare Provider Details

I. General information

NPI: 1457362303
Provider Name (Legal Business Name): JEWISH FAMILY SERVICES OF DELAWARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 09/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 PASSMORE DR
WILMINGTON DE
19803-1548
US

IV. Provider business mailing address

99 PASSMORE DR
WILMINGTON DE
19803-1548
US

V. Phone/Fax

Practice location:
  • Phone: 302-478-9411
  • Fax: 302-479-9883
Mailing address:
  • Phone: 302-478-9411
  • Fax: 302-479-9883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0000333
License Number StateDE

VIII. Authorized Official

Name: MS. PATRICIA LAWSON
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 302-478-9411