Provider Demographics
NPI:1225737026
Name:DIRECT CARE TRANSPORTATION AGENCY
Entity Type:Organization
Organization Name:DIRECT CARE TRANSPORTATION AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEKENGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-341-5858
Mailing Address - Street 1:3100 E 45TH ST STE 118
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44127-1094
Mailing Address - Country:US
Mailing Address - Phone:216-341-5858
Mailing Address - Fax:
Practice Address - Street 1:3100 E 45TH ST STE 118
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44127-1094
Practice Address - Country:US
Practice Address - Phone:216-341-5858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)