Organization
ISAIAH HOME 613 INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONI FOUNTAIN (EXECUTIVE DIRECTOR)
(302) 275-8938
Entity
Organization
Contact information
Practice address
260 CHAPMAN RD STE 104B, NEWARK, DE 19702-5410
(302) 499-2326
Mailing address
260 CHAPMAN RD STE 104B, NEWARK, DE 19702-5410
(302) 499-2326
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
06/29/2022
Last updated
03/23/2026
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