Provider Demographics
NPI:1679704746
Name:CONNECTIONS CSP, INC.
Entity Type:Organization
Organization Name:CONNECTIONS CSP, INC.
Other - Org Name:CONNECTIONS DDDS RESIDENTIAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP PROGRAM OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-984-3380
Mailing Address - Street 1:500 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1422
Mailing Address - Country:US
Mailing Address - Phone:302-984-3380
Mailing Address - Fax:302-994-3329
Practice Address - Street 1:500 W 10TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1422
Practice Address - Country:US
Practice Address - Phone:302-984-3380
Practice Address - Fax:302-994-3329
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONNECTIONS CSP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-06
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE617330Medicare PIN