Provider Demographics
NPI:1053952598
Name:ATLANTIC RECOVERY INSTITUTE AND ADVOCACY CENTER LLC
Entity type:Organization
Organization Name:ATLANTIC RECOVERY INSTITUTE AND ADVOCACY CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRITZGES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:302-632-2204
Mailing Address - Street 1:110 S DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-1447
Mailing Address - Country:US
Mailing Address - Phone:302-632-2204
Mailing Address - Fax:
Practice Address - Street 1:110 S DELAWARE ST
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-1447
Practice Address - Country:US
Practice Address - Phone:302-632-2204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-07
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE250607302Medicaid