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STATE OF DELAWARE-STOCKLEY

Intermediate Care Facility, Mentally Retarded

Georgetown, Delaware

Provider NPI: 1962557561

Organization Information:
Organization Name:  STATE OF DELAWARE-STOCKLEY


Practice Location:
26351 PATRIOTS WAY  GEORGETOWN, DE 19947 US
Tel: 302-933-3000  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
DE1047

Other Provider Identifiers:

IssuerNumberStateType
0000031813DE05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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