Provider Demographics
NPI:1508225905
Name:CONNECTIONS CSP BRANDYWINE STREET WOMEN'S RESIDENTIAL TREATMENT PROGRA
Entity Type:Organization
Organization Name:CONNECTIONS CSP BRANDYWINE STREET WOMEN'S RESIDENTIAL TREATMENT PROGRA
Other - Org Name:CONNECTIONS BRANDYWINE STREET WOMEN'S RESIDENTIAL TREATMENT PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVANEY MCKAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-230-9103
Mailing Address - Street 1:3821 LANCASTER PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-1512
Mailing Address - Country:US
Mailing Address - Phone:302-442-6622
Mailing Address - Fax:302-984-3385
Practice Address - Street 1:1120 BRANDYWINE ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-5219
Practice Address - Country:US
Practice Address - Phone:302-250-5883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONNECTIONS COMMUNITY SUPPORT PROGRAMS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-15
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder