MEDICARE: DIRECT CARE TRAINING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174H00000X	Health Educator

General Provider Information

NPI Number	:	1851703839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIRECT CARE TRAINING, LLC

Provider Business Mailing Address
First Line	:	609 LYNNHAVEN PKWY
Second Line	:	SUITE 206
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-7336
Country	:	US
Telephone Number	:	757-277-6586
Fax Number	:	757-271-9074

Provider Business Practice Location Address
First Line	:	609 LYNNHAVEN PKWY
Second Line	:	SUITE 206
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-7336
Country	:	US
Telephone Number	:	757-277-6586
Fax Number	:	757-271-9074

Authorized Official
Title or Position	:	ADMINISTRATOR/OWNER
Name	:	MS. STEPHANIE E LAMBERT
Credential	:	LPN
Telephone Number	:	757-277-6586

Provider Enumeration Date	:	05/27/2014
Last Update Date	:	05/27/2014

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