Provider Demographics
NPI:1497253298
Name:DIRECT CARE, INC.
Entity Type:Organization
Organization Name:DIRECT CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TOBY
Authorized Official - Middle Name:W
Authorized Official - Last Name:OSBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-436-5001
Mailing Address - Street 1:3006 COMMON ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-8537
Mailing Address - Country:US
Mailing Address - Phone:337-436-5001
Mailing Address - Fax:337-436-5002
Practice Address - Street 1:3006 COMMON ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8537
Practice Address - Country:US
Practice Address - Phone:337-436-5001
Practice Address - Fax:337-436-5002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15394253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2377591Medicaid