Provider Demographics
NPI:1821354374
Name:THE DELTA INFLUENCE LLC
Entity Type:Organization
Organization Name:THE DELTA INFLUENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LIFE COACH/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:G
Authorized Official - Last Name:HILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-945-5557
Mailing Address - Street 1:397 HERITAGE PARK TRCE NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-4832
Mailing Address - Country:US
Mailing Address - Phone:888-945-5557
Mailing Address - Fax:404-963-0808
Practice Address - Street 1:397 HERITAGE PARK TRCE NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-4832
Practice Address - Country:US
Practice Address - Phone:888-945-5557
Practice Address - Fax:404-963-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health