Provider Demographics
NPI:1346794476
Name:COURAGEOUS HEARTS LLC
Entity Type:Organization
Organization Name:COURAGEOUS HEARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUGHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CADC
Authorized Official - Phone:302-593-1378
Mailing Address - Street 1:8848 SEPTEMBER WAY
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:DE
Mailing Address - Zip Code:19960-3267
Mailing Address - Country:US
Mailing Address - Phone:302-593-1378
Mailing Address - Fax:302-265-2790
Practice Address - Street 1:8848 SEPTEMBER WAY
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:DE
Practice Address - Zip Code:19960-3267
Practice Address - Country:US
Practice Address - Phone:302-593-1378
Practice Address - Fax:302-265-2790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-05
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
DEQ1-0000948251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1285883975Medicaid