Provider Demographics
NPI:1871596197
Name:DIRECT HEALTH CARE, INC.
Entity type:Organization
Organization Name:DIRECT HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:VIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-793-3999
Mailing Address - Street 1:7402 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-1456
Mailing Address - Country:US
Mailing Address - Phone:806-793-3999
Mailing Address - Fax:806-793-2592
Practice Address - Street 1:7402 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423
Practice Address - Country:US
Practice Address - Phone:806-793-3999
Practice Address - Fax:806-793-2592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002112251E00000X
253Z00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000012900OtherPHC CONTRACT NUMBER
TX002112OtherSTATE LICENSE