Provider Demographics
NPI:1740010867
Name:DELIGHT MEDICAL STAFFING AGENCY
Entity type:Organization
Organization Name:DELIGHT MEDICAL STAFFING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDELA
Authorized Official - Suffix:I
Authorized Official - Credentials:CMA
Authorized Official - Phone:515-306-1550
Mailing Address - Street 1:6000 NW 62ND AVE UNIT NW62ND
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-1528
Mailing Address - Country:US
Mailing Address - Phone:515-306-1550
Mailing Address - Fax:515-401-0829
Practice Address - Street 1:6000 NW 62ND AVE UNIT NW62ND
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-1528
Practice Address - Country:US
Practice Address - Phone:515-306-1550
Practice Address - Fax:515-401-0829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child