Provider Demographics
NPI:1023508322
Name:FIRST STATE EMPLOYMENT SERVICES
Entity type:Organization
Organization Name:FIRST STATE EMPLOYMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:
Authorized Official - Last Name:GANGLOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-383-0191
Mailing Address - Street 1:524 HARLAN BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-5166
Mailing Address - Country:US
Mailing Address - Phone:302-250-5883
Mailing Address - Fax:302-984-3329
Practice Address - Street 1:524 HARLAN BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-5166
Practice Address - Country:US
Practice Address - Phone:302-250-5883
Practice Address - Fax:302-984-3329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty