1467959593 NPI number — CIMI ENTERPRISES LLC

Table of content: CHRISTI LYNN WILLIAMS PT (NPI 1245244722)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467959593 NPI number — CIMI ENTERPRISES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CIMI ENTERPRISES LLC
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:
CIMI BEHAVIOR ANALYTIC SOLUTIONS
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:
1467959593
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
108 PATRIOT DRIVE
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
MIDDLETOWN
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19709-8803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-803-2210
Provider Business Mailing Address Fax Number:
302-445-7149

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 PATRIOT DRIVE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19709-8803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-803-2210
Provider Business Practice Location Address Fax Number:
302-445-7149
Provider Enumeration Date:
04/05/2018

Additional Information

Authorized Official

Authorized Official Last Name:
CAIRO
Authorized Official First Name:
BETH
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF ADMINISTRATIVE OFFICER
Authorized Official Telephone Number:
302-803-2210

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X , with the licence number:  1-18-29358 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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