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General NPI Number Information
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NPI Number | 1053428615
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Entity Type | Organization
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Legal Business Name | DELTA HOMECARE
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 14 FARMER ST
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City | NEWNAN
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State | GA
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Zip | 30263-1417
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Country | US
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Telephone | 770-502-7912
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Fax | 770-502-7709
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Provider Business Mailing Address
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Address Line | 14 FARMER ST
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City | NEWNAN
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State | GA
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Zip | 30263-1417
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Country | US
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Telephone | 770-502-7912
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Fax | 770-502-7709
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. LOUIS E. KUNTZ
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Credential | M.S.,F.A.C.H.E., CPA
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Telephone | 770-502-7912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 038-R-0002
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License Number State | GA
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