Provider Demographics
NPI:1629367768
Name:DELTA AGENCIES, INC.
Entity Type:Organization
Organization Name:DELTA AGENCIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEROY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-622-6121
Mailing Address - Street 1:501 N ORLANDO AVE
Mailing Address - Street 2:313 PMB 220
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-7313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 N ORLANDO AVE
Practice Address - Street 2:313 PMB 220
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-7313
Practice Address - Country:US
Practice Address - Phone:407-622-6121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)