Provider Demographics
NPI:1215463203
Name:DELTA CARE HOPE FOUNDATION
Entity type:Organization
Organization Name:DELTA CARE HOPE FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER/ADMINSTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:662-299-9616
Mailing Address - Street 1:408 HIGHWAY 82 W
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:MS
Mailing Address - Zip Code:38751-2031
Mailing Address - Country:US
Mailing Address - Phone:662-445-2603
Mailing Address - Fax:
Practice Address - Street 1:408 HIGHWAY 82 W
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751-2031
Practice Address - Country:US
Practice Address - Phone:662-445-2603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care