Provider Demographics
NPI:1558750117
Name:DELIGHTFULL HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:DELIGHTFULL HOME HEALTH CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:AMMA
Authorized Official - Last Name:EERSKINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-580-0925
Mailing Address - Street 1:125 LEDGEWOOD MILL WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-4619
Mailing Address - Country:US
Mailing Address - Phone:404-580-0925
Mailing Address - Fax:770-628-0040
Practice Address - Street 1:125 LEDGEWOOD MILL WAY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-4619
Practice Address - Country:US
Practice Address - Phone:404-580-0925
Practice Address - Fax:770-628-0040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA067-R-1276251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health