Provider Demographics
NPI:1841615473
Name:DIRECT TARGETED CASE MANAGEMENT LLC
Entity Type:Organization
Organization Name:DIRECT TARGETED CASE MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-745-4650
Mailing Address - Street 1:4071 L B MCLEOD RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-5662
Mailing Address - Country:US
Mailing Address - Phone:407-745-4650
Mailing Address - Fax:407-745-4651
Practice Address - Street 1:4071 L B MCLEOD RD
Practice Address - Street 2:SUITE A
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-5662
Practice Address - Country:US
Practice Address - Phone:407-745-4650
Practice Address - Fax:407-745-4651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management