Provider Demographics
NPI:1760776678
Name:NEW BEHAVIORAL NETWORK - DELAWARE INC
Entity Type:Organization
Organization Name:NEW BEHAVIORAL NETWORK - DELAWARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:KARL
Authorized Official - Last Name:BOETTCHER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:856-669-0217
Mailing Address - Street 1:240 N JAMES ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NEWPORT
Mailing Address - State:DE
Mailing Address - Zip Code:19804-3169
Mailing Address - Country:US
Mailing Address - Phone:302-892-9210
Mailing Address - Fax:
Practice Address - Street 1:240 N JAMES ST
Practice Address - Street 2:SUITE 203
Practice Address - City:NEWPORT
Practice Address - State:DE
Practice Address - Zip Code:19804-3169
Practice Address - Country:US
Practice Address - Phone:302-892-9210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management