Provider Demographics
NPI:1629393947
Name:DDC GROUP INC
Entity type:Organization
Organization Name:DDC GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:LUERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-619-3111
Mailing Address - Street 1:10536 SUCCESS LN
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-3561
Mailing Address - Country:US
Mailing Address - Phone:937-619-3111
Mailing Address - Fax:
Practice Address - Street 1:10536 SUCCESS LN
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-3561
Practice Address - Country:US
Practice Address - Phone:937-619-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-30
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3009809Medicaid