Provider Demographics
NPI:1619365012
Name:STATE OF DELAWARE/DSAMH PROMISE
Entity Type:Organization
Organization Name:STATE OF DELAWARE/DSAMH PROMISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL SERVICES CHIEF ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-255-9430
Mailing Address - Street 1:1901 N DUPONT HWY
Mailing Address - Street 2:SPRINGER BUILDING, ROOM 305 HERMAN HOLLOWAY CAMPUS
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-1100
Mailing Address - Country:US
Mailing Address - Phone:302-255-9430
Mailing Address - Fax:302-255-9395
Practice Address - Street 1:1901 N DUPONT HWY
Practice Address - Street 2:SPRINGER BUILDING, ROOM 305 HERMAN HOLLOWAY CAMPUS
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-1100
Practice Address - Country:US
Practice Address - Phone:302-255-9430
Practice Address - Fax:302-255-9395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)