Provider Demographics
NPI:1376058800
Name:CHRISTIANA CARE HEALTH INITIATIVES
Entity Type:Organization
Organization Name:CHRISTIANA CARE HEALTH INITIATIVES
Other - Org Name:CCHI BEHAVIORAL HEALTH NJ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT AND CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:CORRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-623-7203
Mailing Address - Street 1:200 HYGEIA DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:302-623-7362
Mailing Address - Fax:
Practice Address - Street 1:125 EAST AVE STE C
Practice Address - Street 2:
Practice Address - City:WOODSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08098-1351
Practice Address - Country:US
Practice Address - Phone:856-769-2800
Practice Address - Fax:856-769-4256
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTIANA CARE HEALTH INITIATIVES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty