Provider Demographics
NPI:1649720046
Name:DIRECT CARE COORDINATION, INC
Entity type:Organization
Organization Name:DIRECT CARE COORDINATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VALENTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALIBOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-779-1628
Mailing Address - Street 1:2789 BUTTERCUP CT
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-5455
Mailing Address - Country:US
Mailing Address - Phone:215-779-1628
Mailing Address - Fax:
Practice Address - Street 1:2789 BUTTERCUP CT
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-5455
Practice Address - Country:US
Practice Address - Phone:215-779-1628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management