Healthcare Provider Details

I. General information

NPI: 1194277483
Provider Name (Legal Business Name): QUAYLE HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5155 W THUNDERBIRD RD
GLENDALE AZ
85306-4836
US

IV. Provider business mailing address

29697 N 69TH DR
PEORIA AZ
85383-3178
US

V. Phone/Fax

Practice location:
  • Phone: 443-636-0686
  • Fax: 602-532-7857
Mailing address:
  • Phone: 443-636-0686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberQ09201613534
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: ANGELA L BAZEMORE QUAYE
Title or Position: CLINICAL DIRECTOR
Credential: DBH, CFNC, CEAP, SAP
Phone: 443-636-0686