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Organization
BAY AREA DIRECT CLIENT CARE LLC
Active
Organization
BAY AREA DIRECT CLIENT CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESHAE MARTIN APRN (ADMINISTRATIVE DIRECTOR)
(813) 679-5122
Entity
Organization
Contact information
Practice address
110 LITHIA PINECREST RD STE B, BRANDON, FL 33511-5300
(813) 679-5122
(564) 524-5855
Mailing address
2105 ROANOKE SPRINGS DR, RUSKIN, FL 33570-6312
(813) 679-5122
(564) 524-5855
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
NULL
251J00000X
Nursing Care Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
Other
Enumeration date
09/01/2021
Last updated
01/13/2022
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