1477007532 NPI number — CONNECTIONS COMMUNITY SUPPORT PROGRAMS, INC.

Table of content: (NPI 1477007532)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477007532 NPI number — CONNECTIONS COMMUNITY SUPPORT PROGRAMS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONNECTIONS COMMUNITY SUPPORT PROGRAMS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ACT TEAM 5
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477007532
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/06/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3821 LANCASTER PIKE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19805-1512
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1423 CAPITOL TRAIL (BLDG. 1)
Provider Second Line Business Practice Location Address:
SUITE 1302
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-565-6697
Provider Business Practice Location Address Fax Number:
302-304-5347
Provider Enumeration Date:
08/06/2016

Additional Information

Authorized Official

Authorized Official Last Name:
DEVANEY MCKAY
Authorized Official First Name:
CATHERINE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT AND CEO
Authorized Official Telephone Number:
302-230-9103

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com