Basic Information
| Provider Information | |||||||||
| NPI: | 1336334267 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WILMINGTON PSYCHIATRIC SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 71 OMEGA DR | ||||||||
| Address2: | BUILDING D | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197132063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3022833300 | ||||||||
| FaxNumber: | 3022833321 | ||||||||
| Practice Location | |||||||||
| Address1: | 5143A W WOODMILL DR | ||||||||
| Address2: | SUITE 24 | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198084067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3029998426 | ||||||||
| FaxNumber: | 3029998761 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2007 | ||||||||
| LastUpdateDate: | 03/10/2011 | ||||||||
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| AuthorizedOfficialLastName: | SINGH | ||||||||
| AuthorizedOfficialFirstName: | RAMNIK | ||||||||
| AuthorizedOfficialMiddleName: | K. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3029998426 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | C1-0007689 | DE | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No ID Information.