Provider Demographics
NPI:1942082383
Name:DRC ENTERPRISES LLC
Entity Type:Organization
Organization Name:DRC ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DATASHA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-634-1711
Mailing Address - Street 1:1015 BENJAMIN AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-3222
Mailing Address - Country:US
Mailing Address - Phone:616-634-1711
Mailing Address - Fax:616-245-7216
Practice Address - Street 1:1015 BENJAMIN AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-3222
Practice Address - Country:US
Practice Address - Phone:616-634-1711
Practice Address - Fax:616-245-7216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care