Provider Demographics
NPI:1376870881
Name:DELBERG LLC
Entity Type:Organization
Organization Name:DELBERG LLC
Other - Org Name:DELBERG HOME HEALTH CARE AGENCY
Other - Org Type:Other Name
Authorized Official - Title/Position:FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIEDRA
Authorized Official - Middle Name:DIANA
Authorized Official - Last Name:CHATMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-892-0500
Mailing Address - Street 1:13453 N. MAIN STREET
Mailing Address - Street 2:SUITE # 206
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218
Mailing Address - Country:US
Mailing Address - Phone:904-680-1317
Mailing Address - Fax:904-371-8451
Practice Address - Street 1:13453 N. MAIN STREET
Practice Address - Street 2:SUITE 206
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218
Practice Address - Country:US
Practice Address - Phone:904-680-1317
Practice Address - Fax:904-371-8451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health