Provider Demographics
NPI:1801198544
Name:OPEN DOOR INCORPORATED
Entity Type:Organization
Organization Name:OPEN DOOR INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:WIILIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DIFABIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-636-1488
Mailing Address - Street 1:3301 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703-2052
Mailing Address - Country:US
Mailing Address - Phone:302-798-9555
Mailing Address - Fax:302-798-9550
Practice Address - Street 1:3301 GREEN ST
Practice Address - Street 2:
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-2052
Practice Address - Country:US
Practice Address - Phone:302-798-9555
Practice Address - Fax:302-198-9550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder