Provider Demographics
NPI:1699658252
Name:VASSALLO'S MENTAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:VASSALLO'S MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:VASSALLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-723-1924
Mailing Address - Street 1:205 GLEN BERNE DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19804-3409
Mailing Address - Country:US
Mailing Address - Phone:302-723-1924
Mailing Address - Fax:
Practice Address - Street 1:205 GLEN BERNE DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19804-3409
Practice Address - Country:US
Practice Address - Phone:302-723-1924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health