OrganizationActive
Traditional Community Living
NPI 1679849046 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Lincoln, DE
Provider details
- NPI number
- 1679849046
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Kimberly Johnson, Owner(302) 424-0907
- License
- 20120227152 (DE)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityPrimary320600000XLicense 20120227152 (DE)
Residential Treatment Facilities
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
8367 Brick Granary Road
Lincoln, DE 19960
Phone: (302) 424-0907
Street-level locationGet directions
Mailing address
8367 Brick Granary Rd
Lincoln, DE 19960-3812
Registry dates
- Enumerated
- 2012-03-29
- Last updated
- 2012-03-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.