Provider Demographics
NPI:1124179718
Name:CARELINK COMMUNITY SUPPORT SERVICES OF DE, INC
Entity Type:Organization
Organization Name:CARELINK COMMUNITY SUPPORT SERVICES OF DE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-874-1119
Mailing Address - Street 1:1510 CHESTER PIKE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:EDDYSTONE
Mailing Address - State:PA
Mailing Address - Zip Code:19022-1375
Mailing Address - Country:US
Mailing Address - Phone:610-874-1119
Mailing Address - Fax:610-872-3407
Practice Address - Street 1:100 W 10TH ST
Practice Address - Street 2:SUITE 601
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-6603
Practice Address - Country:US
Practice Address - Phone:302-429-6693
Practice Address - Fax:302-429-8031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE851802Medicaid