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NPI Code Detail

MEDICARE: BRANDYWINE ASSISTED LIVING AT FENWICK ISLAND, LLC

MEDICARE: BRANDYWINE ASSISTED LIVING AT FENWICK ISLAND, LLC
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
1310400000XAssisted Living Facility2192DE

General Provider Information

NPI Number : 1609023092
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRANDYWINE ASSISTED LIVING AT FENWICK ISLAND, LLC
Provider Business Mailing Address
First Line : 21111 ARRINGTON DRIVE
Second Line :
City : SELBYVILLE
State : DE
Zip : 19975
Country : US
Telephone Number : 302-436-0808
Fax Number :
Provider Business Practice Location Address
First Line : 21111 ARRINGTON DRIVE
Second Line :
City : SELBYVILLE
State : DE
Zip : 19975
Country : US
Telephone Number : 302-436-0808
Fax Number :
Authorized Official
Title or Position : CONTRACT MANAGER
Name : MELISSA B LINTEAU
Credential :
Telephone Number : 908-686-3233
Provider Enumeration Date : 08/27/2008
Last Update Date : 08/27/2008

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Directions to “BRANDYWINE ASSISTED LIVING AT FENWICK ISLAND, LLC ” Practice Location

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