Provider Demographics
NPI:1912499336
Name:DNE DIRECT CARE SERVICES LLC
Entity Type:Organization
Organization Name:DNE DIRECT CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEONIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCQUEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-208-4339
Mailing Address - Street 1:1602 GOVERNORS DR APT 1623
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-9435
Mailing Address - Country:US
Mailing Address - Phone:850-208-4339
Mailing Address - Fax:
Practice Address - Street 1:1602 GOVERNORS DR APT 1623
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-9435
Practice Address - Country:US
Practice Address - Phone:850-208-4339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities