Provider Demographics
NPI:1174278014
Name:DIRECT CARE TELEHEALTH
Entity Type:Organization
Organization Name:DIRECT CARE TELEHEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICAELA
Authorized Official - Middle Name:
Authorized Official - Last Name:STREVAY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:207-740-3666
Mailing Address - Street 1:919 N DYSART RD STE F
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-1711
Mailing Address - Country:US
Mailing Address - Phone:480-701-8235
Mailing Address - Fax:480-701-8235
Practice Address - Street 1:27418 N 93RD ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85262-9015
Practice Address - Country:US
Practice Address - Phone:831-818-9833
Practice Address - Fax:480-701-8235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1881970622OtherNPI
1770951618OtherNPI
1689284911OtherNPI
1760805384OtherNPI
1902497373OtherNPI
1972506616OtherNPI