MEDICARE: QUALITY CARE LLC

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	320800000X	Mental Illness Community Based Residential Treatment Facility

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	:	1568107548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY CARE LLC

Provider Business Mailing Address
First Line	:	5101 OBANNON DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3447
Country	:	US
Telephone Number	:	702-306-0323
Fax Number	:

Provider Business Practice Location Address
First Line	:	5101 OBANNON DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3447
Country	:	US
Telephone Number	:	702-306-0323
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID CRAWFORD
Credential	:
Telephone Number	:	702-306-0323

Provider Enumeration Date	:	05/03/2022
Last Update Date	:	05/03/2022

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Directions to “QUALITY CARE LLC ” Practice Location

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