| Full Name | Dyhv |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 200 S Dupont St, Wilmington, Delaware |
| Authorized Official Name and Position | Moneak C. Baskerville (CEO) |
| Authorized Official Contact | 3027400746 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dyhv 3 N Redspire Ct Newark DE 19702-3947 Ph: (302) 834-5242 | Dyhv 200 S Dupont St Wilmington DE 19805-3972 Ph: (302) 429-4118 |
| NPI Number | 1053448803 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 01/10/2020 |
| Certification Date | 01/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053448803 | NPI | - | NPPES |
| 250552890 | Medicaid | DE | |
| 0097250 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | 37PC00337200 (New Jersey) | Primary |
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