St. Augustine Health System Delaware LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

ST. AUGUSTINE HEALTH SYSTEM DELAWARE LLC

Practice address

200 Continental Dr Ste 401
Newark, DE 19713-4337

Phone

(443) 703-9933

NPI assigned

Oct 13, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Augustine Jacobson

Title

Chief Executive Officer

Phone

(443) 703-9933

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1932825635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7004 SECURITY BLVD STE 300",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212442534",
            "telephone_number": "443-703-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CONTINENTAL DR STE 401",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197134337",
            "telephone_number": "443-703-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. AUGUSTINE HEALTH SYSTEM DELAWARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "AUGUSTINE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "443-703-9933",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Newark, DE
• Providers in Newark, DE by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.