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General NPI Number Information
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NPI Number | 1619291663
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Entity Type | Organization
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Legal Business Name | THORNSBERRY BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 03/19/2010
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Last Update Date | 02/19/2013
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Provider Practice Location Address
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Address Line | 750 KINGS HWY SUITE 101-B
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City | LEWES
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State | DE
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Zip | 19958-1772
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Country | US
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Telephone | 302-858-2019
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Fax | 302-644-6953
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Provider Business Mailing Address
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Address Line | 750 KINGS HWY SUITE 101-B
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City | LEWES
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State | DE
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Zip | 19958-1772
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Country | US
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Telephone | 302-858-2019
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Fax | 302-644-6953
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL JEROME THORNSBERRY
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Credential | LCSW, CADC
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Telephone | 302-858-2019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | Q1-0000975
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License Number State | DE
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