Provider Demographics
NPI:1861541609
Name:AQUILA OF DELAWARE, INC.
Entity type:Organization
Organization Name:AQUILA OF DELAWARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHATTERTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LCSW
Authorized Official - Phone:302-376-8610
Mailing Address - Street 1:1812 NEWPORT GAP PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-6179
Mailing Address - Country:US
Mailing Address - Phone:302-999-1106
Mailing Address - Fax:302-999-1753
Practice Address - Street 1:1812 NEWPORT GAP PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-6179
Practice Address - Country:US
Practice Address - Phone:302-999-1106
Practice Address - Fax:302-999-1753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1991830288261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0602528OtherAETNA
DE37761OtherCIGNA
DEA066181OtherVALUE OPTIONS
DE159139OtherBLUE CROSS BLUE SHIELD DE
DE174428OtherCOMPSYCH