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
119 BROADWAY ST, DELHI, LA 71232-2903
(318) 878-9017
(318) 878-2585
Mailing address
115 BROADWAY ST, PO BOX 727, DELHI, LA 71232-2903
(318) 878-9058
(318) 878-9053
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
499
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1717312
PROVIDER # TALLULAH CH
LA
Enumeration date
03/20/2007
Last updated
08/22/2020
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