North Delta Staffing Services

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

NORTH DELTA STAFFING SERVICES

Practice address

520 Goodman Rd E
Southaven, MS 38671-9526

Phone

(662) 393-0170

Fax

(662) 393-0171

NPI assigned

Jul 21, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Raymond E Vallier

Title

Ceo/Administrator

Phone

(662) 393-0170

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469059200000",
    "number": "1295188506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 GOODMAN RD E",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719526",
            "telephone_number": "662-393-0170",
            "fax_number": "662-393-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 GOODMAN RD E",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719526",
            "telephone_number": "662-393-0170",
            "fax_number": "662-393-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH DELTA STAFFING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-21",
        "last_updated": "2016-07-21",
        "status": "A",
        "authorized_official_last_name": "VALLIER",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "662-393-0170"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02005311",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07236817",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Southaven, MS
• Providers in Southaven, MS by specialty
• In Home Supportive Care Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.