Provider Demographics
NPI:1689925331
Name:DIRECT COMMUNITY CARE, LLC, PA
Entity Type:Organization
Organization Name:DIRECT COMMUNITY CARE, LLC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:ALBEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-512-2424
Mailing Address - Street 1:9 GREEN ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-7451
Mailing Address - Country:US
Mailing Address - Phone:207-512-2424
Mailing Address - Fax:207-512-2425
Practice Address - Street 1:9 GREEN ST
Practice Address - Street 2:SUITE 304
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-7451
Practice Address - Country:US
Practice Address - Phone:207-512-2424
Practice Address - Fax:207-512-2425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-20
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME658525251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health