Provider Demographics
NPI:1275711236
Name:ADVANCED TREATMENT OPTIONS, LLC
Entity Type:Organization
Organization Name:ADVANCED TREATMENT OPTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:GIBBLE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, BC
Authorized Official - Phone:888-517-2088
Mailing Address - Street 1:604 MILLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-2227
Mailing Address - Country:US
Mailing Address - Phone:888-517-2088
Mailing Address - Fax:302-998-3242
Practice Address - Street 1:604 MILLTOWN RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-2227
Practice Address - Country:US
Practice Address - Phone:888-517-2088
Practice Address - Fax:302-998-3242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00005711041C0700X
DEDN-0000351133V00000X
DELE-0000158364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty