State of Delaware-DDDS As.Liv

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

1481 Issued in DE

Legal business name

STATE OF DELAWARE-DDDS AS.LIV

Practice address

26351 Patriots Way
Georgetown, DE 19947-2575

Phone

(302) 933-3000

NPI assigned

Jan 25, 2007

Last updated

Feb 26, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Nicole F. Johnson

Title

Social Service Chief Administrator

Phone

(302) 741-9349

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DDDS Assisted Living Other name

Tax ID family

Psychiatry Delaware Sta131 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Dental Health Center of del-Tech

  • Dental Clinic/Center
  • Wilmington, DE
  • NPI 1114057825
  NPD tax ID
• State of de

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New Castle, DE
  • NPI 1104582816
  NPD tax ID
• State of Delaware

  • Student Health Clinic/Center
  • Dover, DE
  • NPI 1003984410
  NPD tax ID
• State of Delaware

  • State or Local Public Health Clinic/Center
  • Dover, DE
  • NPI 1003995267
  NPD tax ID
• State of Delaware

  dba Campus Community Charter School

  • Local Education Agency (LEA)
  • Dover, DE
  • NPI 1013051986
  NPD tax ID
• State of Delaware

  • State or Local Public Health Clinic/Center
  • Dover, DE
  • NPI 1013082171
  NPD tax ID
• State of Delaware

  • Public Health or Welfare Agency
  • Dover, DE
  • NPI 1013089895
  NPD tax ID
• State of Delaware

  dba Cape Henlopen School District

  • Local Education Agency (LEA)
  • Lewes, DE
  • NPI 1023152998
  NPD tax ID
• State of Delaware

  • State or Local Public Health Clinic/Center
  • Dover, DE
  • NPI 1033298294
  NPD tax ID
• State of Delaware

  • State or Local Public Health Clinic/Center
  • Dover, DE
  • NPI 1043385404
  NPD tax ID
• State of Delaware

  • Student Health Clinic/Center
  • Dover, DE
  • NPI 1063580470
  NPD tax ID
• State of Delaware

  dba Seaford School District

  • Local Education Agency (LEA)
  • Seaford, DE
  • NPI 1093859704
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614297600000",
    "number": "1093860264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1056 S GOVERNORS AVE",
            "address_2": "WOODBROOK PROFESSIONAL CTR, STE. 101",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199046920",
            "telephone_number": "302-744-9600",
            "fax_number": "302-744-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26351 PATRIOTS WAY",
            "city": "GEORGETOWN",
            "state": "DE",
            "postal_code": "199472575",
            "telephone_number": "302-933-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF DELAWARE-DDDS AS.LIV",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "SOCIAL SERVICE CHIEF ADMINISTRATOR",
        "authorized_official_telephone_number": "302-741-9349",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "DE",
            "license": "1481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001150374",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DDDS Assisted Living",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "DDDS Assisted Living",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Hayley A Sprague, O.D.
• Lisa Staab, CRNP
• Jessica Stag, OTR/L
• State of Delaware
• State of Delaware (Sussex Technical School District)
• State of Delaware-Stockley
• Steady Steps Physical Therapy
• David Stewart, FNP-C PMHNP-BC
• Janet P Stoer, RN
• Jacob Stoker, M.D.

• Assisted Living Facility in Georgetown, DE
• Providers in Georgetown, DE by specialty
• Assisted Living Facility in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.