Provider Demographics
NPI:1164575569
Name:AIDS DELAWARE, INC.
Entity Type:Organization
Organization Name:AIDS DELAWARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MPA, CFRE
Authorized Official - Phone:302-652-6776
Mailing Address - Street 1:100 W 10TH ST
Mailing Address - Street 2:SUITE 315
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-6603
Mailing Address - Country:US
Mailing Address - Phone:302-652-6776
Mailing Address - Fax:302-652-5150
Practice Address - Street 1:100 W 10TH ST
Practice Address - Street 2:SUITE 315
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-6603
Practice Address - Country:US
Practice Address - Phone:302-652-6776
Practice Address - Fax:302-652-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE103TH0100N251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000574157Medicaid