# 412 DIRECT CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114852647
- **Authorized official:** NCHIMA CHIBAYE CNP (CEO)
- **Authorized official phone:** (412) 623-9101

## Contact information

- **Practice address:** 1499 BRENTFIELD DR, WADSWORTH, OH 44281-6204
- **Practice address phone:** (412) 623-9101
- **Mailing address:** 1499 BRENTFIELD DR, WADSWORTH, OH 44281-6204
- **Mailing address phone:** (412) 623-9101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 202K00000X | Phlebology Physician | — | NULL | — |
| 202K00000X | Phlebology Physician | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/16/2026
- **Last updated:** 06/16/2026