Healthcare Provider Details

I. General information

NPI: 1508226796
Provider Name (Legal Business Name): CONNECTIONS COMMUNITY SUPPORT PROGRAMS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2016
Last Update Date: 03/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3821 LANCASTER PIKE
WILMINGTON DE
19805-1512
US

IV. Provider business mailing address

3821 LANCASTER PIKE
WILMINGTON DE
19805-1512
US

V. Phone/Fax

Practice location:
  • Phone: 302-442-6622
  • Fax: 302-984-3324
Mailing address:
  • Phone: 302-442-6622
  • Fax: 302-984-3324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRIS DEVANEY
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 302-230-9102