NPI 1679849046

Traditional Community Living

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Lincoln, DE

Practice location

Address: 8367 Brick Granary Road, Lincoln, DE 19960
Phone: (302) 424-0907
Mailing address: 8367 Brick Granary Rd, Lincoln, DE 19960-3812

Authorised official

Name: Kimberly G Johnson
Title: Owner
Phone: (302) 424-0907

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence 20120227152 (DE)

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Delaware →

Registry record

NPI: 1679849046
Entity type: Organization
NPI issued: 29 Mar 2012
Record last updated: 29 Mar 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.