Healthcare Provider Details

I. General information

NPI: 1972768059
Provider Name (Legal Business Name): DELTA HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17515 W 9 MILE RD STE 525
SOUTHFIELD MI
48075-4420
US

IV. Provider business mailing address

17515 W 9 MILE RD STE 525
SOUTHFIELD MI
48075-4420
US

V. Phone/Fax

Practice location:
  • Phone: 248-905-3087
  • Fax: 888-335-6559
Mailing address:
  • Phone: 248-905-3087
  • Fax: 888-335-6559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMI

VIII. Authorized Official

Name: RUBY SCOTT
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 248-905-3087