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General NPI Number Information
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NPI Number | 1841001195
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Entity Type | Organization
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Legal Business Name | DIRECT SUPPORT PROFESSIONALS, LLC
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 5248 OLDE TOWNE RD STE 6
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-1986
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Country | US
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Telephone | 757-800-7028
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Fax |
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Provider Business Mailing Address
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Address Line | 9404 SUNSET CT APT 423
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City | MANASSAS PARK
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State | VA
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Zip | 20111-8294
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Country | US
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Telephone | 571-298-7075
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MARIA FUTRELL
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Credential |
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Telephone | 571-298-7075
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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 |
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License Number State |
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