Healthcare Provider Details

I. General information

NPI: 1700455375
Provider Name (Legal Business Name): DIRECT ASSISTED SERVICES OF HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2021
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 YORK RD STE 800
LUTHERVILLE MD
21093-6011
US

IV. Provider business mailing address

1301 YORK RD STE 800
LUTHERVILLE MD
21093-6011
US

V. Phone/Fax

Practice location:
  • Phone: 410-303-1383
  • Fax:
Mailing address:
  • Phone: 410-303-1383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TYRA ALSTON
Title or Position: OWNER ADMINISTRATOR
Credential:
Phone: 410-303-1383