1982904496 NPI number — DELTA HOME HEALTH CARE, INC.

Table of content: (NPI 1982904496)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982904496 NPI number — DELTA HOME HEALTH CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DELTA HOME HEALTH CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CAPITOL HOME HEALTH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982904496
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/04/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9015 MOUNTAIN RIDGE DRIVE
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78759
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-467-6900
Provider Business Mailing Address Fax Number:
512-467-6906

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2800 N. CENTRAL AVENUE
Provider Second Line Business Practice Location Address:
SUITE 1020
Provider Business Practice Location Address City Name:
PHEONIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-368-2045
Provider Business Practice Location Address Fax Number:
602-368-2965
Provider Enumeration Date:
10/30/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHULTS
Authorized Official First Name:
KELSEY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
512-467-6900

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)