Provider Demographics
NPI:1518036342
Name:OPPORTUNITY CENTER INC
Entity Type:Organization
Organization Name:OPPORTUNITY CENTER INC
Other - Org Name:OCI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF METRO REGION
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-461-6140
Mailing Address - Street 1:3030 BOWERS STREET
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802
Mailing Address - Country:US
Mailing Address - Phone:302-762-0300
Mailing Address - Fax:302-762-8795
Practice Address - Street 1:3030 BOWERS STREET
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802
Practice Address - Country:US
Practice Address - Phone:302-762-0300
Practice Address - Fax:302-762-8795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE103TM1800X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
Not Answered103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000032307Medicaid