Provider Demographics
NPI:1710585021
Name:AQUILA OF DELAWARE, INC.
Entity Type:Organization
Organization Name:AQUILA OF DELAWARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-999-1106
Mailing Address - Street 1:4185 KIRKWOOD ST GEORGES RD
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-2272
Mailing Address - Country:US
Mailing Address - Phone:302-999-1106
Mailing Address - Fax:
Practice Address - Street 1:4185 KIRKWOOD ST GEORGES RD
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-2272
Practice Address - Country:US
Practice Address - Phone:302-834-7806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-09
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder