Provider Demographics
NPI:1104365790
Name:CHRISTIANA CARE HEALTH SERVICES INC
Entity Type:Organization
Organization Name:CHRISTIANA CARE HEALTH SERVICES INC
Other - Org Name:CCHS WELLNESS CTR - CONRAD HIGH SCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:MCMURRAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:302-428-2522
Mailing Address - Street 1:200 HYGEIA DR
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 JACKSON AVE
Practice Address - Street 2:CONRAD SCHOOLS OF SCIENCE
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19804-2125
Practice Address - Country:US
Practice Address - Phone:302-992-5545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTIANA CARE HEALTH SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-16
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchoolGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty