Provider Demographics
NPI:1982904496
Name:DELTA HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:DELTA HOME HEALTH CARE, INC.
Other - Org Name:CAPITOL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHULTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-467-6900
Mailing Address - Street 1:9015 MOUNTAIN RIDGE DRIVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759
Mailing Address - Country:US
Mailing Address - Phone:512-467-6900
Mailing Address - Fax:512-467-6906
Practice Address - Street 1:2800 N. CENTRAL AVENUE
Practice Address - Street 2:SUITE 1020
Practice Address - City:PHEONIX
Practice Address - State:AZ
Practice Address - Zip Code:85004
Practice Address - Country:US
Practice Address - Phone:602-368-2045
Practice Address - Fax:602-368-2965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-30
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ037407Medicare UPIN