State of De
NPI #1609895762 in Wilmington, Delaware
Provider Information
- NPI Number
- 1609895762
- Entity Type
- Organization
- Organization Name
- State of De
- Primary Specialty
- Clinic/Center - Mental Health (Including Community Mental Health Center)
- Enumeration Date
- Jul 19, 2006
- Last Updated
- Dec 31, 2008
Practice Location
- Address
- 809 N WASHINGTON ST
- City
- Wilmington
- State
- Delaware
- ZIP Code
- 19801-1509
- Phone
- (302) 577-6490
Authorized Official
- Name
- MR. STANLEY J KOTULA
- Title
- MEDICAL DIRECTOR/DIRECTOR OF CLINCI
- Phone
- (302) 576-6093
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center) |
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