| De Kent Act 1 | |
|
1695 South State Street Suite A Dover DE 19901-5148 | |
| (302) 268-4537 | |
| Not Available |
| Full Name | De Kent Act 1 |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1695 South State Street Suite A, Dover, Delaware |
| Authorized Official Name and Position | Marco Giordano (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2159510300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| De Kent Act 1 4700 Wissahickon Ave Suite 126 Philadelphia PA 19144-4248 Ph: (215) 951-0300 | De Kent Act 1 1695 South State Street Suite A Dover DE 19901-5148 Ph: (302) 268-4537 |
| NPI Number | 1962758243 |
|---|---|
| Provider Enumeration Date | 07/24/2012 |
| Last Update Date | 11/13/2023 |
| Certification Date | 11/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962758243 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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