Organization Name: | DELTA CENTER INC. |
NPI Number: | 1043585581 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LISA TOLBER (EXECUTIVE DIRECTOR) |
Mailing Address: | 208 12th St Cairo |
State: | IL US |
Postal Code: | 629141928 |
Phone Number: | 6187342665 |
Fax Number: | 6187341999 |
NPI Enumeration Date: | 03/16/2012 |
NPI Last Update Date: | 03/16/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM2800X |
License Number: | 04045 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Methadone Clinic |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |