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General NPI Number Information
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NPI Number | 1154451839
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Entity Type | Organization
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Legal Business Name | CAPTAINS DECK, INC.
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7807 GOVERNOR PRINTZ BLVD
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City | CLAYMONT
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State | DE
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Zip | 19703-2624
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Country | US
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Telephone | 302-798-3500
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Fax | 302-798-7662
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Provider Business Mailing Address
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Address Line | 102 ROBINO CT STE 301
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City | WILMINGTON
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State | DE
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Zip | 19804-2365
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Country | US
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Telephone | 302-995-7011
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Fax | 302-995-6030
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Authorized Official
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Title or Position | ACCOUNT MANAGER
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Name | MRS. NICOLE K MCCALL
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Credential |
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Telephone | 302-995-7011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 2002107729
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License Number State | DE
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