| Port In The Storm Llc | |
|
600 W Division St Dover DE 19904-2702 | |
| (302) 735-7738 | |
| (302) 735-8560 |
| Full Name | Port In The Storm Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 600 W Division St, Dover, Delaware |
| Authorized Official Name and Position | Sandra A Dyer (THERAPIST) |
| Authorized Official Contact | 3027357738 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Port In The Storm Llc 600 W Division St Dover DE 19904-2702 Ph: (302) 735-7738 | Port In The Storm Llc 600 W Division St Dover DE 19904-2702 Ph: (302) 735-7738 |
| NPI Number | 1861630188 |
|---|---|
| Provider Enumeration Date | 01/23/2009 |
| Last Update Date | 08/18/2015 |
| Medicare PECOS PAC ID | 1254515364 |
|---|---|
| Medicare Enrollment ID | O20110414000590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861630188 | NPI | - | NPPES |
| 1000021573 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | Q1-0000296 (Delaware) | Primary |
| Provider Name | Sandra A. Dyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891702304 PECOS PAC ID: 2163606278 Enrollment ID: I20110414000604 |
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