State of Delaware-Stockley
Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Georgetown, DE
NPI 1962557561 · NPPES record last updated Feb 26, 2021
Key facts
- NPI
- 1962557561
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual Disabilities Intermediate Care Facility 315P00000X
- License
- 1047 (DE)
- Legal business name
- STATE OF DELAWARE-STOCKLEY
- Practice address
- 26351 Patriots Way
Georgetown, DE 19947-2575 - Phone
- (302) 933-3000
- Fax
- (302) 934-1376
- NPI assigned
- Jan 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Nicole F. Johnson
- Title
- Social Service Chief Administrator
- Phone
- (302) 741-9349
Corporate family (same tax ID) 5
Practitioners 110
-
Jillian Coleen Abbott, FNP-C
-
Borislav S. Antonov, M.D.
-
Ryan E Arias, DO
-
Philemon Parker Bailey, D.O.
-
Lisa Bartels, MD
-
Welisane Bebe, MD
-
Vittoria Boni, MD
-
Anthony P Buonanno Jr., M.D.
-
Nicole Marie Caselli, FNP-BC
-
Luis J Castro, MD
-
William M Chasanov II, D.O.
-
Linda Choy, M.D.
-
Colleen Cimo, FNP
-
Caitlin Crotty, DNP
-
Gwen Elizabeth Davis, FNP-BC; PMHNP-BC
-
Tracy L Dysard, NP
-
Tiffany L. Hyett Edwards, FNP-BC
-
Ahmad Elayyan, MD
National Provider Directory
- Tax ID family
- Jeffrey Hawtof MD
Locations
12100 Black Swan Dr
Lewes, DE 19958
Phone (302) 645-1315
232 Mitchell St
Fl 3
Millsboro, DE 19966
Phone (302) 316-4190
32060 Long Neck Rd
Millsboro, DE 19966
Phone (302) 645-3150
18947 John J Williams Hwy
Unit 205
Rehoboth Beach, DE 19971
Phone (302) 644-0964
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 1047 | DE | Yes |
Addresses
Primary practice location
26351 Patriots Way
Georgetown, DE 19947-2575
Mailing address
26351 Patriots Way
Georgetown, DE 19947-2575
Phone (302) 933-3000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000031813 | Medicaid | DE |
Other names
- Stockley Center
Other providers in Georgetown, DE
- Lisa Staab
- Jessica Stag
- State of Delaware
- State of Delaware
- State of Delaware-DDDS As.Liv
- Steady Steps Physical Therapy
- David Stewart
- Janet P Stoer
- Jacob Stoker
- Stokley Center
All providers in Georgetown, DE · Intellectual Disabilities Intermediate Care Facility in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.