MEDICARE: DELTA HOMECARE HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1225315922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELTA HOMECARE HEALTH

Provider Business Mailing Address
First Line	:	2442 S COLLINS ST
Second Line	:	108
City	:	ARLINGTON
State	:	TX
Zip	:	76014-1238
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2442 S COLLINS ST
Second Line	:	108
City	:	ARLINGTON
State	:	TX
Zip	:	76014-1238
Country	:	US
Telephone Number	:	972-859-9676
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE MANAGER
Name	:	MOHAMED JAMA
Credential	:
Telephone Number	:	972-859-9676

Provider Enumeration Date	:	11/08/2011
Last Update Date	:	11/08/2011

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