Provider Demographics
NPI:1346691821
Name:DIRECT FAMILY CARE, INC.
Entity Type:Organization
Organization Name:DIRECT FAMILY CARE, INC.
Other - Org Name:CDPAP MARKS HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANAT
Authorized Official - Middle Name:
Authorized Official - Last Name:GANZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-713-0005
Mailing Address - Street 1:9717 64TH RD
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2261
Mailing Address - Country:US
Mailing Address - Phone:718-713-0005
Mailing Address - Fax:
Practice Address - Street 1:9717 64TH RD
Practice Address - Street 2:4TH FLOOR
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2261
Practice Address - Country:US
Practice Address - Phone:718-713-0005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-27
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4489332Medicaid