Provider Demographics
NPI:1851686869
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 1:1575 MCKEE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-1382
Mailing Address - Country:US
Mailing Address - Phone:302-730-0720
Mailing Address - Fax:302-730-0725
Practice Address - Street 1:1575 MCKEE RD STE 201
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-1382
Practice Address - Country:US
Practice Address - Phone:302-730-0720
Practice Address - Fax:302-730-0725
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW BEHAVIORAL NETWORK-DELAWARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-17
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health