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General NPI Number Information
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NPI Number | 1528449030
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Entity Type | Organization
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Legal Business Name | DRC SUPPORT SERVICES
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Dates
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Enumeration Date | 06/11/2015
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Last Update Date | 06/11/2015
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Provider Practice Location Address
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Address Line | 9 W KING ST
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City | QUINCY
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State | FL
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Zip | 32351-1701
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Country | US
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Telephone | 313-701-5785
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Fax | 850-627-2630
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Provider Business Mailing Address
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Address Line | 9 W KING ST
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City | QUINCY
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State | FL
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Zip | 32351-1701
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Country | US
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Telephone | 313-701-5785
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Fax | 850-627-2630
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Authorized Official
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Title or Position | CEO
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Name | MISS DARLENE ROLLINS CUNNINGHAM
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Credential |
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Telephone | 313-701-5785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 233901
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License Number State | FL
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