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General NPI Number Information
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NPI Number | 1780968107
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Entity Type | Organization
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Legal Business Name | DELTA REGIONAL HOLDINGS LLC
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Dates
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Enumeration Date | 10/04/2011
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Last Update Date | 10/04/2011
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Provider Practice Location Address
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Address Line | 1634 TELFAIR ST
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City | DUBLIN
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State | GA
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Zip | 31021-3115
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Country | US
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Telephone | 478-272-1133
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Fax |
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Provider Business Mailing Address
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Address Line | 1634 TELFAIR ST
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City | DUBLIN
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State | GA
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Zip | 31021-3115
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Country | US
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Telephone | 478-272-1133
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MS. LYNDA S. HEBBELN
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Credential |
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Telephone | 727-723-3021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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