Provider Demographics
NPI:1982889283
Name:DIRECT CARE PERSONNEL, L.L.C.
Entity Type:Organization
Organization Name:DIRECT CARE PERSONNEL, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DONNEL
Authorized Official - Suffix:
Authorized Official - Credentials:CO OWNER
Authorized Official - Phone:623-935-4948
Mailing Address - Street 1:12540 W SAN MIGUEL AVE
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-3827
Mailing Address - Country:US
Mailing Address - Phone:623-935-4948
Mailing Address - Fax:
Practice Address - Street 1:12540 W SAN MIGUEL AVE
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-3827
Practice Address - Country:US
Practice Address - Phone:623-935-4948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ01034385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care