Provider Demographics
NPI:1568989473
Name:BRANDYWINE RESEARCH ASSOCIATES LLC
Entity Type:Organization
Organization Name:BRANDYWINE RESEARCH ASSOCIATES LLC
Other - Org Name:INTERIM PERSONAL CARE AND SUPPORT LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MANNINO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:302-322-2743
Mailing Address - Street 1:100 S MAIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-1479
Mailing Address - Country:US
Mailing Address - Phone:302-322-2743
Mailing Address - Fax:302-328-5086
Practice Address - Street 1:100 SOUTH MAIN STREET
Practice Address - Street 2:SUITE 203
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977
Practice Address - Country:US
Practice Address - Phone:302-322-2743
Practice Address - Fax:302-328-5086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPASA054253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE179310168OtherBUSINESS LICENSE