Provider Demographics
NPI:1033722046
Name:CONNECTIONS COMMUNITY SUPPORT PROGRAMS INC.
Entity Type:Organization
Organization Name:CONNECTIONS COMMUNITY SUPPORT PROGRAMS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEVON
Authorized Official - Middle Name:Z
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-377-2358
Mailing Address - Street 1:3821 LANCASTER PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-1512
Mailing Address - Country:US
Mailing Address - Phone:302-377-2358
Mailing Address - Fax:302-984-3385
Practice Address - Street 1:706 PORT PENN RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-8926
Practice Address - Country:US
Practice Address - Phone:833-886-2277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)