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General NPI Number Information
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NPI Number | 1104960079
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Entity Type | Organization
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Legal Business Name | STATE OF DELAWARE
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | 104 SAULSBURY RD
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City | DOVER
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State | DE
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Zip | 19904-2705
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Country | US
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Telephone | 302-674-0684
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Fax |
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Provider Business Mailing Address
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Address Line | 104 SAULSBURY RD
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City | DOVER
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State | DE
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Zip | 19904-2705
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Country | US
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Telephone | 302-674-0684
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Fax | 302-674-3894
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Authorized Official
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Title or Position | PRINCIPAL
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Name | NOEL RODRIGUEZ
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Credential |
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Telephone | 302-674-0684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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