| Camden West Group Home | |
|
124 N West St Camden DE 19934-1234 | |
| (302) 531-1103 | |
| (302) 531-1105 |
| Full Name | Camden West Group Home |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 124 N West St, Camden, 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 |
|---|---|
| Camden West Group Home 3821 Lancaster Pike Wilmington DE 19805-1512 Ph: (302) 442-6622 | Camden West Group Home 124 N West St Camden DE 19934-1234 Ph: (302) 531-1103 |
| NPI Number | 1023177714 |
|---|---|
| Provider Enumeration Date | 12/08/2006 |
| Last Update Date | 09/14/2020 |
| Certification Date | 09/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023177714 | NPI | - | NPPES |
| 0000520061 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1516 (Delaware) | Primary |
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