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NPI Code Detail

MEDICARE: LIFESTREAM BEHAVIORAL HEALTH

MEDICARE: LIFESTREAM BEHAVIORAL HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1578147971
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFESTREAM BEHAVIORAL HEALTH
Provider Business Mailing Address
First Line : 1201 PHILADELPHIA PIKE
Second Line :
City : WILMINGTON
State : DE
Zip : 19809-2042
Country : US
Telephone Number : 302-798-4400
Fax Number : 302-798-3002
Provider Business Practice Location Address
First Line : 1201 PHILADELPHIA PIKE
Second Line :
City : WILMINGTON
State : DE
Zip : 19809-2042
Country : US
Telephone Number : 302-798-4400
Fax Number : 302-798-3002
Authorized Official
Title or Position : OWNER
Name : MATTHEW J MCILRATH
Credential : DC
Telephone Number : 23-798-7033
Provider Enumeration Date : 05/11/2021
Last Update Date : 05/11/2021

Similar Medicare Providers

1801984828 — MR. MATTHEW J AY MCILRATH D.C.
Practice Location Address:
1201 PHILADELPHIA PIKE
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1235799933 — MR. JAMES MARVIN JACK JR. LPC
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Practice Fax:
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Practice Fax:
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Practice Location Address:
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Practice Fax:
1982337127 — CAROL JANE HOPKINS LPCMH
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Practice Fax:

Directions to “LIFESTREAM BEHAVIORAL HEALTH ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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