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General NPI Number Information
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NPI Number | 1861527129
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Entity Type | Organization
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Legal Business Name | DELTA HOME CARE, LLC.
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 08/31/2007
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Provider Practice Location Address
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Address Line | 3410 HEALY DR SUITE 213
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City | WINSTON SALEM
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State | NC
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Zip | 27103-1403
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Country | US
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Telephone | 336-765-5025
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Fax | 336-765-5024
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Provider Business Mailing Address
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Address Line | 3410 HEALY DR SUITE 213
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City | WINSTON SALEM
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State | NC
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Zip | 27103-1403
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Country | US
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Telephone | 336-765-5025
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Fax | 336-765-5024
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Authorized Official
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Title or Position | AGENCY DIRECTOR
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Name | MRS. JULIA WHITE MCKOY
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Credential |
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Telephone | 336-765-5025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | HC2385
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License Number State | NC
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