Provider Demographics
NPI:1972933885
Name:KENT-SUSSEX INDUSTRIES
Entity type:Organization
Organization Name:KENT-SUSSEX INDUSTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-422-4014
Mailing Address - Street 1:301 N REHOBOTH BLVD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-1305
Mailing Address - Country:US
Mailing Address - Phone:302-422-4014
Mailing Address - Fax:302-422-5848
Practice Address - Street 1:301 N REHOBOTH BLVD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1305
Practice Address - Country:US
Practice Address - Phone:302-422-4014
Practice Address - Fax:302-422-5848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEA000000009Medicaid
DEA00000022Medicaid
DEA000000003Medicaid