Healthcare Provider Details

I. General information

NPI: 1174144083
Provider Name (Legal Business Name): UBUNTU BLACK FAMILY WELLNESS COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2020
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2611 GOVERNOR PRINTZ BLVD
WILMINGTON DE
19802-4518
US

IV. Provider business mailing address

101 W NEWTOWN PL
NEWARK DE
19702-2975
US

V. Phone/Fax

Practice location:
  • Phone: 302-709-1838
  • Fax:
Mailing address:
  • Phone: 615-830-7722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHELLE LATANYA DREW
Title or Position: DIRECTOR
Credential: DNP,CNM, FNP-C, RN
Phone: 615-830-7722