Healthcare Provider Details

I. General information

NPI: 1639415094
Provider Name (Legal Business Name): AMERICAN QUALITY HOME CARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2012
Last Update Date: 12/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 HOLBROOK TER NE APT 2
WASHINGTON DC
20002-2714
US

IV. Provider business mailing address

1215 HOLBROOK TER NE APT 2
WASHINGTON DC
20002-2714
US

V. Phone/Fax

Practice location:
  • Phone: 202-538-4693
  • Fax:
Mailing address:
  • Phone: 202-538-4693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number29664105
License Number StateDC

VIII. Authorized Official

Name: ROBERT L JOHNSON JR.
Title or Position: HOME HEALTH AIDE
Credential:
Phone: 202-538-4693