Provider Demographics
NPI:1073901229
Name:MESSIAHS ANGEL FOUNDATION CENTER
Entity Type:Organization
Organization Name:MESSIAHS ANGEL FOUNDATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGGIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-365-5516
Mailing Address - Street 1:PO BOX 1151
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-7151
Mailing Address - Country:US
Mailing Address - Phone:302-365-5516
Mailing Address - Fax:
Practice Address - Street 1:400-402 FOX HUNT DR
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-2537
Practice Address - Country:US
Practice Address - Phone:302-365-5516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-22
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2013104573261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care