- Enrollment id
- O20100615000636
- Enrollment state
- MS
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1649295684
- Multiple npi flag
- N
- Ccn
- 257115
- Associate id
- 9638209844
- Organization name
- MID-DELTA HOME HEALTH, INC.
- Incorporation date
- 1978-03-15
- Incorporation state
- MS
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 405 N HAYDEN ST
- City
- BELZONI
- State
- MS
- Zip code
- 390383639