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General NPI Number Information
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NPI Number | 1518297662
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Entity Type | Organization
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Legal Business Name | DIRECTCARE COMMUNITY BASED SERVICES,LLC
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 01/12/2010
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Provider Practice Location Address
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Address Line | 132 W MAIN ST
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City | FOREST CITY
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State | NC
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Zip | 28043-3023
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Country | US
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Telephone | 828-305-4330
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 261
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City | CROUSE
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State | NC
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Zip | 28033-0261
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | BARRANCE TODD ROBERTS
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Credential |
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Telephone | 828-305-4330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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