Provider Demographics
NPI:1215534318
Name:STANFORD COMMUNITY DEVELOPMENT CORPORATION
Entity Type:Organization
Organization Name:STANFORD COMMUNITY DEVELOPMENT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:STANFORD-DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-401-8649
Mailing Address - Street 1:500 WEST LOOCKERMAN STREET
Mailing Address - Street 2:DUNCAN CENTER SUITE 400
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904
Mailing Address - Country:US
Mailing Address - Phone:302-401-8649
Mailing Address - Fax:
Practice Address - Street 1:500 WEST LOOCKERMAN STREET
Practice Address - Street 2:SUITE 400 (DUNCAN CENTER)
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904
Practice Address - Country:US
Practice Address - Phone:302-401-8649
Practice Address - Fax:302-264-9771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-02
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty
No3416A0800XTransportation ServicesAmbulanceAir TransportGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
No374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing PersonnelGroup - Multi-Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty