Provider Demographics
NPI:1619336765
Name:DELICATE HOME CARE AGENCYCOORPORATION
Entity type:Organization
Organization Name:DELICATE HOME CARE AGENCYCOORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.O.O
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:NELL
Authorized Official - Last Name:JONES HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:856-385-8800
Mailing Address - Street 1:141 S BLACK HORSE PIKE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2975
Mailing Address - Country:US
Mailing Address - Phone:856-385-8800
Mailing Address - Fax:856-385-8820
Practice Address - Street 1:141 S BLACK HORSE PIKE
Practice Address - Street 2:SUITE 106
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-2975
Practice Address - Country:US
Practice Address - Phone:856-385-8800
Practice Address - Fax:856-385-8820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0220600251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health