Provider Demographics
NPI:1528449030
Name:DRC SUPPORT SERVICES
Entity type:Organization
Organization Name:DRC SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:ROLLINS
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-701-5785
Mailing Address - Street 1:9 W KING ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32351-1701
Mailing Address - Country:US
Mailing Address - Phone:313-701-5785
Mailing Address - Fax:850-627-2630
Practice Address - Street 1:9 W KING ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32351-1701
Practice Address - Country:US
Practice Address - Phone:313-701-5785
Practice Address - Fax:850-627-2630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL233901253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care