State Of Delaware
Clinic/Center, Mental Health (Including Community Mental Health Center) in Dover, DE. Organization (NPI-2).
NPI number1104871920
StatusActive
Last updated in NPPESFeb 25, 2020
Details
- NPI
- 1104871920
- Entity type
- Organization (NPI-2)
- Legal business name
- State Of Delaware
- Organization subpart
- No
- Enumeration date
- May 23, 2006
- Certification date
- Feb 25, 2020
- Last updated
- Feb 25, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Other names
- Kent/Sussex Community Mental Health Center (Doing Business As)
Practice location
805 River RdDover, DE 19901-3753
Phone 302-739-4275
Mailing address
10 Sw Front StMilford, DE 19963-1948
Phone 302-422-1422
Authorized official
Stanley J Kotula
Medical Director/Director Of Clinic
3025766093
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