| NPI | 1972206498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE BELL-CORNISH Medical Director 302-294-6593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2023-03-23 |
| Last Update Date | 2024-07-23 |