Provider Demographics
NPI:1851440697
Name:AQUILA OF DELAWARE, INC.
Entity Type:Organization
Organization Name:AQUILA OF DELAWARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHATTERTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LCSW
Authorized Official - Phone:302-856-9746
Mailing Address - Street 1:6 N RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-1242
Mailing Address - Country:US
Mailing Address - Phone:302-856-9746
Mailing Address - Fax:302-856-9766
Practice Address - Street 1:6 N RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-1242
Practice Address - Country:US
Practice Address - Phone:302-856-9746
Practice Address - Fax:302-856-9766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1991830288261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE174428OtherCOMPSYCH
DE159139OtherBLUE CROSS BLUE SHIELD DE
DEA066181OtherVALUE OPTIONS
DE0602528OtherAETNA
DE37761OtherCIGNA