MEDICARE: DIRECT QUALITY CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3104A0630X	Assisted Living Facility (Behavioral Disturbances)

General Provider Information

NPI Number	:	1114870201
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIRECT QUALITY CARE LLC

Provider Business Mailing Address
First Line	:	4222 MILWAUKEE ST STE 23
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53714-3537
Country	:	US
Telephone Number	:	608-733-0197
Fax Number	:	608-820-0549

Provider Business Practice Location Address
First Line	:	405 PAWLING ST
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53704-5019
Country	:	US
Telephone Number	:	608-733-0197
Fax Number	:	608-820-0549

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SHAFI MOHAMED
Credential	:
Telephone Number	:	608-733-0197

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	02/18/2026

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