# TRADITIONAL COMMUNITY LIVING

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679849046
- **Authorized official:** MRS. KIMBERLY G JOHNSON (OWNER)
- **Authorized official phone:** (302) 424-0907

## Contact information

- **Practice address:** 8367 BRICK GRANARY ROAD, LINCOLN, DE 19960
- **Practice address phone:** (302) 424-0907
- **Mailing address:** 8367 BRICK GRANARY RD, LINCOLN, DE 19960-3812
- **Mailing address phone:** (302) 424-0907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 20120227152 | DE | Yes |

## Other

- **Enumeration date:** 03/29/2012
- **Last updated:** 03/29/2012