Provider Demographics
NPI:1316397565
Name:DEDICATED CARE HEALTH SERVICES INC
Entity Type:Organization
Organization Name:DEDICATED CARE HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:AMIBANG
Authorized Official - Last Name:TANUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-257-3504
Mailing Address - Street 1:5571 SAINT CHARLES DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-3537
Mailing Address - Country:US
Mailing Address - Phone:301-257-3504
Mailing Address - Fax:
Practice Address - Street 1:5571 SAINT CHARLES DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-3537
Practice Address - Country:US
Practice Address - Phone:301-257-3504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health