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:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
26351 PATRIOTS WAY GEORGETOWN, DE 19947 US
Tel: 302-933-3000 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded | DE | 1047 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
0000031813 | DE | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin