Organization
MODERN MATURITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN FREDRICKS (PRESIDENT/CEO)
(302) 734-1200
Entity
Organization
Contact information
Practice address
1125 FORREST AVE, DOVER, DE 19904
(302) 734-1200
(302) 346-5340
Mailing address
1121 FORREST AVE, DOVER, DE 19904-3308
(302) 734-1200
(302) 674-1265
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
ADC-001
DE
251J00000X
Nursing Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/04/2007
Last updated
01/13/2023
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