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NPI Code Detail

MEDICARE: DELTA CARE INC

MEDICARE: DELTA CARE INC
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
1251S00000XCommunity/Behavioral Health Agency100082ANCA

General Provider Information

NPI Number : 1467782102
Entity Type Code : Organization
Provider Name (Legal Business Name) : DELTA CARE INC
Provider Business Mailing Address
First Line : 4705 N SONORA AVE STE 113
Second Line :
City : FRESNO
State : CA
Zip : 93722-3965
Country : US
Telephone Number : 559-276-7558
Fax Number : 559-276-7568
Provider Business Practice Location Address
First Line : 4705 N SONORA AVE
Second Line : SUITE 113
City : FRESNO
State : CA
Zip : 93722-3966
Country : US
Telephone Number : 559-276-7558
Fax Number : 559-276-7568
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MRS. RITA OBIAJULUM ENUNWA
Credential : MSN, FNP-C
Telephone Number : 559-276-7558
Provider Enumeration Date : 12/31/2009
Last Update Date : 07/14/2023

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Directions to “DELTA CARE INC ” Practice Location

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