Organization Active NPI

Ingleside Homes, Inc

  • Assisted Living Facility
  • Wilmington, DE
National Provider Identifier
1164563797
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
2031 Issued in DE
Legal business name
INGLESIDE HOMES, INC
Practice address
1605 N Broom St
Wilmington, DE 19806-3009
Phone
(302) 984-0950
Fax
(302) 984-0955
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Authorized official

Name
Ms. Susan W Jonas
Title
Controller
Phone
(302) 575-0283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 2031 DE Primary

Addresses

Primary practice location

1605 N Broom St
Wilmington, DE 19806-3009

Mailing address

1605 N Broom St
Wilmington, DE 19806-3009
Phone (302) 504-0654

Other identifiers 1

IdentifierTypeStateIssuer
1000041286MedicaidDE

Other names 1

  • Ingleside Assisted Living Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Ingleside Homes Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1164563797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 N BROOM ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198063009",
            "telephone_number": "302-504-0654",
            "fax_number": "302-575-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 N BROOM ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198063009",
            "telephone_number": "302-984-0950",
            "fax_number": "302-984-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGLESIDE HOMES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "JONAS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "302-575-0283",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "DE",
            "license": "2031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000041286",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ingleside Assisted Living",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.