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Organization

DELTA AMERICAN HEALTHCARE, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JESSE PRISOCK (ACCOUNTANT)
(318) 878-9058
Entity
Organization

Contact information

Practice address
115 BROADWAY ST, DELHI, LA 71232-2903
(318) 878-9058
(318) 878-9053
Mailing address
115 BROADWAY ST, DELHI, LA 71232-2903
(318) 878-9058
(318) 878-9053

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
385H00000X
Respite Care
Primary
3913
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1170780
LA
05
1435520
LA
05
1540978
LA
05
1671851
LA
05
1713171
LA
05
1713414
LA
05
1713457
LA
05
1717312
LA
05
1717690
LA
05
1718394
LA
05
1718408
LA
05
1718416
LA
05
1718513
LA
05
1718530
LA
05
1718556
LA
05
1718564
LA
05
1913120
LA
05
1979104
LA
Enumeration date
01/31/2008
Last updated
01/31/2008
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