Provider Demographics
NPI:1093325177
Name:DIRECT CARE MANAGEMENT INC.
Entity Type:Organization
Organization Name:DIRECT CARE MANAGEMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:TERRY
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-478-4264
Mailing Address - Street 1:12150 TRIBUTARY POINT DR STE 200
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-4531
Mailing Address - Country:US
Mailing Address - Phone:888-478-4264
Mailing Address - Fax:888-413-0267
Practice Address - Street 1:12150 TRIBUTARY POINT DR STE 200
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-4531
Practice Address - Country:US
Practice Address - Phone:888-478-4264
Practice Address - Fax:888-413-0267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-04
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies