Provider Demographics
NPI:1811424583
Name:CONNECTIONS COMMUNITY SUPPORT PROGRAMS INC.
Entity Type:Organization
Organization Name:CONNECTIONS COMMUNITY SUPPORT PROGRAMS INC.
Other - Org Name:CLINT WALKER GROUP HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVANEY MCKAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-230-9103
Mailing Address - Street 1:3821 LANCASTER PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-1512
Mailing Address - Country:US
Mailing Address - Phone:302-442-6622
Mailing Address - Fax:302-984-3385
Practice Address - Street 1:676 BLACK DIAMOND RD
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-9670
Practice Address - Country:US
Practice Address - Phone:302-389-1118
Practice Address - Fax:302-389-1121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-12
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)