Organization
STATE OF DE
Active
Other names
NC Community Mental Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STANLEY J KOTULA (MEDICAL DIRECTOR/DIRECTOR OF CLINCI)
(302) 576-6093
Entity
Organization
Contact information
Practice address
809 N WASHINGTON ST, WILMINGTON, DE 19801-1509
(302) 577-6490
Mailing address
10 SW FRONT ST, MILFORD, DE 19963-1948
(302) 422-1422
(302) 422-1375
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
609724
—
DE
Enumeration date
07/19/2006
Last updated
12/31/2008
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