Provider Demographics
NPI:1023665874
Name:CARE AT HOME OF DELAWARE, LLC
Entity type:Organization
Organization Name:CARE AT HOME OF DELAWARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MORRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERZELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:302-442-3600
Mailing Address - Street 1:20 MONTCHANIN RD STE 50
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19807-2179
Mailing Address - Country:US
Mailing Address - Phone:302-502-7138
Mailing Address - Fax:
Practice Address - Street 1:20 MONTCHANIN RD STE 50
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19807-2179
Practice Address - Country:US
Practice Address - Phone:302-502-7138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000000OtherMEDICAID MCO'S