Healthcare Provider Details

I. General information

NPI: 1972453868
Provider Name (Legal Business Name): BRANDYWINE CENTER FOR AUTISM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 DUTCHMANS LN STE A2
EASTON MD
21601-4302
US

IV. Provider business mailing address

510 PHILADELPHIA PIKE
WILMINGTON DE
19809-2100
US

V. Phone/Fax

Practice location:
  • Phone: 302-327-9215
  • Fax:
Mailing address:
  • Phone:
  • Fax: 302-348-9028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VALPRESIOUS HAM
Title or Position: OPERATIONS DIRECTOR
Credential:
Phone: 302-327-9215