Provider Demographics
NPI:1780725135
Name:DIRECT CARE, INC.
Entity type:Organization
Organization Name:DIRECT CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GERI
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-474-7090
Mailing Address - Street 1:300 E MCNEESE ST
Mailing Address - Street 2:SUITE 3-A
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-5700
Mailing Address - Country:US
Mailing Address - Phone:337-474-7090
Mailing Address - Fax:337-474-7079
Practice Address - Street 1:300 E MCNEESE ST
Practice Address - Street 2:SUITE 3-A
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5700
Practice Address - Country:US
Practice Address - Phone:337-474-7090
Practice Address - Fax:337-474-7079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12236251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1116564Medicaid