| Blackbird Landing Group Home | |
|
994 Blackbird Landing Rd Townsend DE 19734-9141 | |
| (302) 659-0512 | |
| (302) 659-3949 |
| Full Name | Blackbird Landing Group Home |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 994 Blackbird Landing Rd, Townsend, Delaware |
| Authorized Official Name and Position | Jevon Z Hicks (DIRECTOR) |
| Authorized Official Contact | 3023772358 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blackbird Landing Group Home 3821 Lancaster Pike Wilmington DE 19805-1512 Ph: (302) 442-6622 | Blackbird Landing Group Home 994 Blackbird Landing Rd Townsend DE 19734-9141 Ph: (302) 659-0512 |
| NPI Number | 1053470260 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 11/11/2020 |
| Certification Date | 11/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053470260 | NPI | - | NPPES |
| 0001185561 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1518 (Delaware) | Primary |
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