Organization · NPI-2

412 Direct Care LLC

Nurse Practitioner, Primary Care · Wadsworth, OH

NPI number1114852647

StatusActive

Last updated in NPPESJun 16, 2026

Details

NPI: 1114852647
Entity type: Organization (NPI-2)
Legal business name: 412 Direct Care LLC
Organization subpart: No
Enumeration date: Jun 16, 2026
Certification date: Jun 16, 2026
Last updated: Jun 16, 2026

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LP2300X	Nurse Practitioner, Primary Care	–	–	Yes
101YM0800X	Counselor, Mental Health	–	–
163W00000X	Registered Nurse	–	–
202K00000X	Phlebology	–	–

Practice location

1499 Brentfield Dr
Wadsworth, OH 44281-6204

Phone 412-623-9101

Mailing address

1499 Brentfield Dr
Wadsworth, OH 44281-6204

Phone 412-623-9101

Authorized official

Nchima Chibaye
Ceo
4126239101

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