MEDICARE: QUALITY SENIOR CARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251J00000X	Nursing Care Agency
2	291U00000X	Clinical Medical Laboratory
3	253Z00000X	In Home Supportive Care Agency
4	332U00000X	Home Delivered Meals
5	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1578357521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY SENIOR CARE LLC

Provider Business Mailing Address
First Line	:	5267 OLD HIGHWAY 11 # D1
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-8859
Country	:	US
Telephone Number	:	601-436-2279
Fax Number	:	833-732-5592

Provider Business Practice Location Address
First Line	:	5267 OLD HIGHWAY 11 # D1
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-8859
Country	:	US
Telephone Number	:	601-436-2279
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	KISHINA JOHNSON
Credential	:	LPN
Telephone Number	:	601-436-2279

Provider Enumeration Date	:	04/07/2025
Last Update Date	:	04/20/2026

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Directions to “QUALITY SENIOR CARE LLC ” Practice Location

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