Provider Demographics
NPI:1952751380
Name:DIRECT CARE SERVICES, INC
Entity Type:Organization
Organization Name:DIRECT CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WANEL
Authorized Official - Middle Name:N
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-441-2229
Mailing Address - Street 1:1106 MACARTHUR DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3122
Mailing Address - Country:US
Mailing Address - Phone:318-441-2229
Mailing Address - Fax:318-442-2755
Practice Address - Street 1:1106 MACARTHUR DR
Practice Address - Street 2:SUITE 6
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3122
Practice Address - Country:US
Practice Address - Phone:318-441-2229
Practice Address - Fax:318-442-2755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15523253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care