Provider Demographics
NPI:1053616532
Name:D.D.C.T. ENTERPRISES
Entity type:Organization
Organization Name:D.D.C.T. ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LATASHIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-324-0638
Mailing Address - Street 1:24455 LAKE SHORE BLVD APT 423
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-1247
Mailing Address - Country:US
Mailing Address - Phone:216-324-0638
Mailing Address - Fax:
Practice Address - Street 1:24455 LAKESHORE BLVD APT 423
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123
Practice Address - Country:US
Practice Address - Phone:216-324-0638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care