| First State Residential Living Llc | |
|
92 Reads Way Unit 108 New Castle DE 19720-1631 | |
| (302) 322-2743 | |
| (302) 450-1368 |
| Full Name | First State Residential Living Llc |
|---|---|
| Speciality | Psychologist - Intellectual & Developmental Disabilities |
| Location | 92 Reads Way Unit 108, New Castle, Delaware |
| Authorized Official Name and Position | Nicholas A. Mannino (PRESIDENT) |
| Authorized Official Contact | 3023222743 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| First State Residential Living Llc 92 Reads Way Unit 108 New Castle DE 19720-1631 Ph: (302) 322-2743 | First State Residential Living Llc 92 Reads Way Unit 108 New Castle DE 19720-1631 Ph: (302) 322-2743 |
| NPI Number | 1790344901 |
|---|---|
| Provider Enumeration Date | 06/11/2019 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790344901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | (* (Not Available)) | Primary |
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