Provider Demographics
NPI:1437371093
Name:DELAWARE FAMILY HEALTHCARE ALLIANCE, INC.
Entity Type:Organization
Organization Name:DELAWARE FAMILY HEALTHCARE ALLIANCE, INC.
Other - Org Name:FAMILY WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:NMI
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:302-677-0515
Mailing Address - Street 1:2114 S DUPONT HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:DE
Mailing Address - Zip Code:19934-1249
Mailing Address - Country:US
Mailing Address - Phone:302-697-0515
Mailing Address - Fax:302-697-0415
Practice Address - Street 1:2114 S DUPONT HWY STE 1
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:DE
Practice Address - Zip Code:19934-1249
Practice Address - Country:US
Practice Address - Phone:302-697-0515
Practice Address - Fax:302-697-0415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2005206803261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care