MEDICARE: QUEST THERAPEUTIC AND PERSONAL CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184816837
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUEST THERAPEUTIC AND PERSONAL CARE, INC.

Provider Business Mailing Address
First Line	:	1914 J.N. PEASE PLACE, SUITE 176
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-4504
Country	:	US
Telephone Number	:	704-712-6122
Fax Number	:	704-919-3463

Provider Business Practice Location Address
First Line	:	1914 JN PEASE PL
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-4504
Country	:	US
Telephone Number	:	704-712-6122
Fax Number	:	704-919-3463

Authorized Official
Title or Position	:	CEO
Name	:	MS. NADINE ROBERTS
Credential	:
Telephone Number	:	704-712-6122

Provider Enumeration Date	:	08/16/2007
Last Update Date	:	02/22/2010

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Directions to “QUEST THERAPEUTIC AND PERSONAL CARE, INC. ” Practice Location

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