Provider Demographics
NPI:1811034044
Name:DELIVERANCE HOME CARE, LLC
Entity Type:Organization
Organization Name:DELIVERANCE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-279-1144
Mailing Address - Street 1:3816 RIVERDALE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-7504
Mailing Address - Country:US
Mailing Address - Phone:336-279-1144
Mailing Address - Fax:336-378-1018
Practice Address - Street 1:2804 RANDLEMAN RD
Practice Address - Street 2:SUITE Q
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-5263
Practice Address - Country:US
Practice Address - Phone:336-279-1144
Practice Address - Fax:336-378-1018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3203251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care