Provider Demographics
NPI:1558657445
Name:CHRISTIANA CARE HEALTH SERVICES INC
Entity Type:Organization
Organization Name:CHRISTIANA CARE HEALTH SERVICES INC
Other - Org Name:CCHS WELLNESS CTR DICKINSON HIGH SCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position: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:SUITE 2502
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 1:1801 MILLTOWN RD
Practice Address - Street 2:DICKINSON HIGH SCHOOL
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4011
Practice Address - Country:US
Practice Address - Phone:302-892-3270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTIANA CARE HEALTH SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty