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General NPI Number Information
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NPI Number | 1841615473
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Entity Type | Organization
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Legal Business Name | DIRECT TARGETED CASE MANAGEMENT LLC
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Dates
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Enumeration Date | 02/18/2014
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Last Update Date | 02/18/2014
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Provider Practice Location Address
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Address Line | 4071 L B MCLEOD RD SUITE A
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City | ORLANDO
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State | FL
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Zip | 32811-5662
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Country | US
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Telephone | 407-745-4650
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Fax | 407-745-4651
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Provider Business Mailing Address
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Address Line | 4071 L B MCLEOD RD SUITE A
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City | ORLANDO
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State | FL
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Zip | 32811-5662
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Country | US
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Telephone | 407-745-4650
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Fax | 407-745-4651
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JUDY WALKER
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Credential |
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Telephone | 407-745-4650
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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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