Provider Demographics
NPI:1699739433
Name:DELTA HOME CARE, INC.
Entity type:Organization
Organization Name:DELTA HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:CHARLYNNE
Authorized Official - Last Name:PAXTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-574-5700
Mailing Address - Street 1:PO BOX 392
Mailing Address - Street 2:9 CROTHERS DRIVE
Mailing Address - City:TALLULAH
Mailing Address - State:LA
Mailing Address - Zip Code:71284-0392
Mailing Address - Country:US
Mailing Address - Phone:318-574-5700
Mailing Address - Fax:318-574-5356
Practice Address - Street 1:9 CROTHERS DR
Practice Address - Street 2:
Practice Address - City:TALLULAH
Practice Address - State:LA
Practice Address - Zip Code:71282-5509
Practice Address - Country:US
Practice Address - Phone:318-574-5700
Practice Address - Fax:318-574-5356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA153251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1401218Medicaid
LA1401218Medicaid