Healthcare Provider Details

I. General information

NPI: 1144412842
Provider Name (Legal Business Name): QUALITY HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 08/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 BROADMOOR DR
LITTLE ROCK AR
72204-3541
US

IV. Provider business mailing address

108 BROADMOOR DR
LITTLE ROCK AR
72204-3541
US

V. Phone/Fax

Practice location:
  • Phone: 501-664-0899
  • Fax: 501-569-9874
Mailing address:
  • Phone: 501-664-0899
  • Fax: 501-569-9874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: PAULINE OKWUOSA
Title or Position: LPN
Credential: LPN
Phone: 501-664-0899