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Organization

FIRST STATE RESIDENTIAL LIVING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICHOLAS A. MANNINO JR. (PRESIDENT)
(302) 322-2743
Entity
Organization

Contact information

Practice address
92 READS WAY UNIT 108, NEW CASTLE, DE 19720-1631
(302) 322-2743
(302) 450-1368
Mailing address
92 READS WAY UNIT 108, NEW CASTLE, DE 19720-1631
(302) 322-2743
(302) 450-1368

Taxonomy

Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary

Other

Enumeration date
06/11/2019
Last updated
06/25/2025
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