Provider Demographics
NPI:1215976618
Name:DELTA CENTER FOR INDEPENDENT LIVING INC.
Entity type:Organization
Organization Name:DELTA CENTER FOR INDEPENDENT LIVING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-926-8761
Mailing Address - Street 1:5933 S HIGHWAY 94
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-5610
Mailing Address - Country:US
Mailing Address - Phone:636-926-8761
Mailing Address - Fax:636-447-0341
Practice Address - Street 1:5933 S HIGHWAY 94
Practice Address - Street 2:SUITE 107
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-5610
Practice Address - Country:US
Practice Address - Phone:636-926-8761
Practice Address - Fax:636-447-0341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty